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 $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $9.12 Typical High $9.12 | Professional | None | $8.91 | $9.12 | $9.12 |
Ambetter Setting Professional Modifier None Typical Low $7.41 Median $8.71 Typical High $11.75 | Professional | None | $7.41 | $8.71 | $11.75 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Medica Setting Facility Modifier None Typical Low $9.33 Median $32.36 Typical High $50.12 | Facility | None | $9.33 | $32.36 | $50.12 |
Medica Setting Professional Modifier None Typical Low $5.37 Median $10.47 Typical High $295.12 | Professional | None | $5.37 | $10.47 | $295.12 |
United Setting Professional Modifier None Typical Low $4.27 Median $5.37 Typical High $10.47 | Professional | None | $4.27 | $5.37 | $10.47 |
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 $4.47 Median $4.47 Typical High $4.47 | Professional | 52 · Reduced service | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.78 Median $1.82 Typical High $1.82 | Professional | 53 · Discontinued | $1.78 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.61 Median $6.76 Typical High $6.76 | Professional | 54 · Surgery only | $6.61 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | 55 · Aftercare only | $1.35 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.89 | $0.89 | $0.89 |
Where Oklahoma sits
The same service costs 4.5 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· 37th of 51
$8.91
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.