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 $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $14.13 Typical High $14.13 | Professional | None | $13.80 | $14.13 | $14.13 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $33.88 Typical High $52.48 | Facility | None | $14.45 | $33.88 | $52.48 |
Medica Setting Professional Modifier None Typical Low $8.32 Median $16.22 Typical High $309.03 | Professional | None | $8.32 | $16.22 | $309.03 |
United Setting Professional Modifier None Typical Low $6.61 Median $8.32 Typical High $16.22 | Professional | None | $6.61 | $8.32 | $16.22 |
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 $6.92 Median $7.08 Typical High $7.08 | Professional | 52 · Reduced service | $6.92 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.82 Typical High $2.82 | Professional | 53 · Discontinued | $2.75 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 54 · Surgery only | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | 55 · Aftercare only | $2.09 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.41 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.38 | $1.41 | $1.41 |
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
$10.00
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.