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 $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $3.31 Median $3.39 Typical High $3.47 | Professional | None | $3.31 | $3.39 | $3.47 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
Medica Setting Facility Modifier None Typical Low $3.55 Median $7.59 Typical High $11.75 | Facility | None | $3.55 | $7.59 | $11.75 |
Medica Setting Professional Modifier None Typical Low $2.04 Median $3.89 Typical High $69.18 | Professional | None | $2.04 | $3.89 | $69.18 |
United Setting Professional Modifier None Typical Low $1.62 Median $2.04 Typical High $3.89 | Professional | None | $1.62 | $2.04 | $3.89 |
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 $1.66 Median $1.70 Typical High $1.70 | Professional | 52 · Reduced service | $1.66 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 53 · Discontinued | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 54 · Surgery only | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.51 Typical High $0.51 | Professional | 55 · Aftercare only | $0.50 | $0.51 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.34 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.33 | $0.34 | $0.34 |
Where Oklahoma sits
The same service costs 3.0 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· 49th of 51
$2.40
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.