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 $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $10.72 Typical High $10.72 | Professional | None | $10.47 | $10.72 | $10.72 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Medica Setting Facility Modifier None Typical Low $11.22 Median $16.60 Typical High $26.30 | Facility | None | $11.22 | $16.60 | $26.30 |
Medica Setting Professional Modifier None Typical Low $6.31 Median $12.30 Typical High $151.36 | Professional | None | $6.31 | $12.30 | $151.36 |
United Setting Professional Modifier None Typical Low $5.13 Median $6.31 Typical High $12.30 | Professional | None | $5.13 | $6.31 | $12.30 |
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 $5.25 Median $5.37 Typical High $5.37 | Professional | 52 · Reduced service | $5.25 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | 53 · Discontinued | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | 54 · Surgery only | $7.94 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.62 Typical High $1.62 | Professional | 55 · Aftercare only | $1.58 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $1.07 |
Where Oklahoma sits
The same service costs 2.7 times more in Idaho 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· 47th of 51
$7.76
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.