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 $0.05 Median $0.05 Typical High $0.33 | Facility | None | $0.05 | $0.05 | $0.33 |
Aetna Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $0.35 | Professional | None | $0.33 | $0.33 | $0.35 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $0.56 Median $0.91 Typical High $1.45 | Facility | None | $0.56 | $0.91 | $1.45 |
Cigna Setting Facility Modifier None Typical Low $0.52 Median $0.52 Typical High $0.52 | Facility | None | $0.52 | $0.52 | $0.52 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Medica Setting Facility Modifier None Typical Low $0.22 Median $0.22 Typical High $0.44 | Facility | None | $0.22 | $0.22 | $0.44 |
Medica Setting Professional Modifier None Typical Low $0.28 Median $0.41 Typical High $41.69 | Professional | None | $0.28 | $0.41 | $41.69 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.34 Typical High $0.34 | Professional | None | $0.28 | $0.34 | $0.34 |
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 $0.17 Median $0.17 Typical High $0.17 | Professional | 52 · Reduced service | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Where Oklahoma sits
The same service costs 1.6 times more in Montana than in Michigan. 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· 46th of 51
$0.35
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.