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 $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $15.49 Typical High $15.49 | Professional | None | $13.80 | $15.49 | $15.49 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Medica Setting Facility Modifier None Typical Low $16.22 Median $19.50 Typical High $134.90 | Facility | None | $16.22 | $19.50 | $134.90 |
Medica Setting Professional Modifier None Typical Low $11.75 Median $20.42 Typical High $158.49 | Professional | None | $11.75 | $20.42 | $158.49 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
United Setting Professional Modifier None Typical Low $9.33 Median $14.13 Typical High $20.42 | Professional | None | $9.33 | $14.13 | $20.42 |
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 $6.76 Median $7.76 Typical High $7.76 | Professional | 52 · Reduced service | $6.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $3.09 Typical High $3.09 | Professional | 53 · Discontinued | $2.75 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.34 Typical High $2.34 | Professional | 55 · Aftercare only | $2.04 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.55 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.38 | $1.55 | $1.55 |
Where Oklahoma sits
The same service costs 2.1 times more in Minnesota than in Washington, DC. 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· 31st of 51
$21.38
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.