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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $25.12 Typical High $25.12 | Professional | None | $24.55 | $25.12 | $25.12 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $30.20 Typical High $48.98 | Facility | None | $25.12 | $30.20 | $48.98 |
Medica Setting Professional Modifier None Typical Low $14.79 Median $28.84 Typical High $269.15 | Professional | None | $14.79 | $28.84 | $269.15 |
United Setting Professional Modifier None Typical Low $11.75 Median $14.79 Typical High $28.84 | Professional | None | $11.75 | $14.79 | $28.84 |
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 $12.30 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $12.30 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $4.90 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 54 · Surgery only | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.45 | $2.51 | $2.51 |
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· 45th of 51
$18.20
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.