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 $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Medica Setting Facility Modifier None Typical Low $15.85 Median $40.74 Typical High $63.10 | Facility | None | $15.85 | $40.74 | $63.10 |
Medica Setting Professional Modifier None Typical Low $9.12 Median $17.78 Typical High $363.08 | Professional | None | $9.12 | $17.78 | $363.08 |
United Setting Professional Modifier None Typical Low $7.24 Median $9.12 Typical High $17.78 | Professional | None | $7.24 | $9.12 | $17.78 |
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 $7.59 Median $7.59 Typical High $7.59 | Professional | 52 · Reduced service | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.09 Typical High $3.09 | Professional | 53 · Discontinued | $3.02 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.22 Median $11.48 Typical High $11.48 | Professional | 54 · Surgery only | $11.22 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.29 Typical High $2.29 | Professional | 55 · Aftercare only | $2.24 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.51 | $1.51 | $1.51 |
Where Oklahoma sits
The same service costs 3.5 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· 41st of 51
$14.13
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.