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 $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $3.24 Typical High $3.47 | Professional | None | $3.16 | $3.24 | $3.47 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Medica Setting Facility Modifier None Typical Low $3.31 Median $9.33 Typical High $14.45 | Facility | None | $3.31 | $9.33 | $14.45 |
Medica Setting Professional Modifier None Typical Low $1.91 Median $3.72 Typical High $83.18 | Professional | None | $1.91 | $3.72 | $83.18 |
United Setting Professional Modifier None Typical Low $1.51 Median $1.91 Typical High $3.72 | Professional | None | $1.51 | $1.91 | $3.72 |
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 $1.58 Median $1.62 Typical High $1.62 | Professional | 52 · Reduced service | $1.58 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.63 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.63 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.34 Median $2.40 Typical High $2.40 | Professional | 54 · Surgery only | $2.34 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.47 Median $0.48 Typical High $0.48 | Professional | 55 · Aftercare only | $0.47 | $0.48 | $0.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $0.32 |
Where Oklahoma sits
The same service costs 3.8 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
$2.45
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.