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 $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Ambetter Setting Professional Modifier None Typical Low $10.96 Median $18.20 Typical High $24.55 | Professional | None | $10.96 | $18.20 | $24.55 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $30.20 Typical High $46.77 | Facility | None | $14.45 | $30.20 | $46.77 |
Medica Setting Professional Modifier None Typical Low $8.32 Median $15.85 Typical High $269.15 | Professional | None | $8.32 | $15.85 | $269.15 |
United Setting Professional Modifier None Typical Low $6.61 Median $8.32 Typical High $15.85 | Professional | None | $6.61 | $8.32 | $15.85 |
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 $6.92 Median $6.92 Typical High $6.92 | Professional | 52 · Reduced service | $6.92 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 53 · Discontinued | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.23 Median $10.47 Typical High $10.47 | Professional | 54 · Surgery only | $10.23 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.09 Typical High $2.09 | Professional | 55 · Aftercare only | $2.04 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.38 | $1.38 | $1.38 |
Where Oklahoma sits
The same service costs 2.9 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· 34th of 51
$13.80
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.