How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $416.87 | Professional | None | $363.08 | $416.87 | $416.87 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $524.81 Typical High $3,388.44 | Facility | None | $436.52 | $524.81 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $478.63 Typical High $4,786.30 | Professional | None | $263.03 | $478.63 | $4,786.30 |
United Setting Facility Modifier None Typical Low $426.58 Median $741.31 Typical High $741.31 | Facility | None | $426.58 | $741.31 | $741.31 |
United Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $478.63 | Professional | None | $213.80 | $316.23 | $478.63 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $181.97 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $72.44 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $54.95 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $36.31 | $41.69 | $41.69 |
Where Oklahoma sits
The same service costs 3.9 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Oklahoma· 30th of 51
$417
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.