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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | None | $30.20 | $30.90 | $30.90 |
Ambetter Setting Professional Modifier None Typical Low $30.20 Median $36.31 Typical High $36.31 | Professional | None | $30.20 | $36.31 | $36.31 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Medica Setting Facility Modifier None Typical Low $31.62 Median $81.28 Typical High $125.89 | Facility | None | $31.62 | $81.28 | $125.89 |
Medica Setting Professional Modifier None Typical Low $18.20 Median $35.48 Typical High $724.44 | Professional | None | $18.20 | $35.48 | $724.44 |
United Setting Professional Modifier None Typical Low $14.45 Median $18.20 Typical High $35.48 | Professional | None | $14.45 | $18.20 | $35.48 |
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 $15.14 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.14 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.03 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $22.91 Typical High $22.91 | Professional | 54 · Surgery only | $22.39 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.02 | $3.09 | $3.09 |
Where Oklahoma sits
The same service costs 2.6 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· 33rd of 51
$30.90
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.