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 $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $13.49 | Professional | None | $11.75 | $11.75 | $13.49 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Medica Setting Facility Modifier None Typical Low $14.13 Median $16.98 Typical High $141.25 | Facility | None | $14.13 | $16.98 | $141.25 |
Medica Setting Professional Modifier None Typical Low $10.96 Median $19.05 Typical High $162.18 | Professional | None | $10.96 | $19.05 | $162.18 |
United Setting Facility Modifier None Typical Low $14.45 Median $30.90 Typical High $30.90 | Facility | None | $14.45 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $8.91 Median $12.30 Typical High $19.05 | Professional | None | $8.91 | $12.30 | $19.05 |
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 $5.89 Median $6.76 Typical High $6.76 | Professional | 52 · Reduced service | $5.89 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.69 Typical High $2.69 | Professional | 53 · Discontinued | $2.34 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $2.00 Typical High $2.00 | Professional | 55 · Aftercare only | $1.78 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.35 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.17 | $1.35 | $1.35 |
Where Oklahoma sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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· 40th of 51
$16.60
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.