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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $50.12 Typical High $50.12 | Professional | None | $48.98 | $50.12 | $50.12 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $97.72 | Facility | None | $50.12 | $60.26 | $97.72 |
Medica Setting Professional Modifier None Typical Low $29.51 Median $57.54 Typical High $549.54 | Professional | None | $29.51 | $57.54 | $549.54 |
United Setting Professional Modifier None Typical Low $23.44 Median $29.51 Typical High $57.54 | Professional | None | $23.44 | $29.51 | $57.54 |
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 $24.55 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $24.55 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $9.77 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 54 · Surgery only | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.90 | $5.01 | $5.01 |
Where Oklahoma sits
The same service costs 2.8 times more in Hawaii 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
$36.31
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.