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 $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.77 | Professional | None | $9.55 | $9.55 | $9.77 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Medica Setting Facility Modifier None Typical Low $10.00 Median $23.99 Typical High $37.15 | Facility | None | $10.00 | $23.99 | $37.15 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $11.22 Typical High $218.78 | Professional | None | $5.75 | $11.22 | $218.78 |
United Setting Professional Modifier None Typical Low $4.57 Median $5.75 Typical High $11.22 | Professional | None | $4.57 | $5.75 | $11.22 |
5 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 $4.79 Median $4.79 Typical High $4.79 | Professional | 52 · Reduced service | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.95 Typical High $1.95 | Professional | 53 · Discontinued | $1.91 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | 54 · Surgery only | $7.08 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $0.95 |
Where Oklahoma sits
The same service costs 3.2 times more in Rhode Island than in New York. 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· 48th of 51
$7.08
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.