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 $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Medica Setting Facility Modifier None Typical Low $4.47 Median $6.92 Typical High $10.72 | Facility | None | $4.47 | $6.92 | $10.72 |
Medica Setting Professional Modifier None Typical Low $2.51 Median $5.01 Typical High $63.10 | Professional | None | $2.51 | $5.01 | $63.10 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.51 Typical High $5.01 | Professional | None | $2.04 | $2.51 | $5.01 |
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 $2.14 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.16 Median $3.24 Typical High $3.24 | Professional | 54 · Surgery only | $3.16 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.63 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.42 | $0.43 | $0.43 |
Where Oklahoma sits
The same service costs 2.7 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· 49th of 51
$3.09
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.