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 $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | None | $158.49 | $181.97 | $181.97 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $229.09 Typical High $1,513.56 | Facility | None | $190.55 | $229.09 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $1,819.70 | Professional | None | $114.82 | $208.93 | $1,819.70 |
United Setting Facility Modifier None Typical Low $186.21 Median $323.59 Typical High $323.59 | Facility | None | $186.21 | $323.59 | $323.59 |
United Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $208.93 | Professional | None | $93.33 | $138.04 | $208.93 |
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 $79.43 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $79.43 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $31.62 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $23.99 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $15.85 | $18.20 | $18.20 |
Where Oklahoma sits
The same service costs 3.5 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· 25th of 51
$200
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.