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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $114.82 | Professional | None | $91.20 | $114.82 | $114.82 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,949.84 Median $3,162.28 Typical High $4,897.79 | Facility | None | $1,949.84 | $3,162.28 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Medica Setting Facility Modifier None Typical Low $31.62 Median $114.82 Typical High $165.96 | Facility | None | $31.62 | $114.82 | $165.96 |
United Setting Facility Modifier None Typical Low $31.62 Median $117.49 Typical High $186.21 | Facility | None | $31.62 | $117.49 | $186.21 |
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 $45.71 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $45.71 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $18.20 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $13.80 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.12 | $11.48 | $11.48 |
Where Oklahoma sits
The same service costs 6.8 times more in North Carolina than in Kentucky. 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· 9th of 51
$166
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.