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 $2.69 Median $2.69 Typical High $2.69 | Facility | None | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $3.09 Typical High $3.09 | Professional | None | $2.69 | $3.09 | $3.09 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Medica Setting Facility Modifier None Typical Low $3.24 Median $3.89 Typical High $79.43 | Facility | None | $3.24 | $3.89 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.34 Median $3.98 Typical High $31.62 | Professional | None | $2.34 | $3.98 | $31.62 |
United Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Facility | None | $6.46 | $6.46 | $6.46 |
United Setting Professional Modifier None Typical Low $1.86 Median $2.82 Typical High $3.98 | Professional | None | $1.86 | $2.82 | $3.98 |
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 $1.35 Median $1.55 Typical High $1.55 | Professional | 52 · Reduced service | $1.35 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.54 Median $0.62 Typical High $0.62 | Professional | 53 · Discontinued | $0.54 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.41 Median $0.47 Typical High $0.47 | Professional | 55 · Aftercare only | $0.41 | $0.47 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.31 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.27 | $0.31 | $0.31 |
Where Oklahoma sits
The same service costs 4.9 times more in Kansas 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
$3.80
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.