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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $53.70 | Professional | None | $48.98 | $53.70 | $53.70 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $54.95 Typical High $95.50 | Facility | None | $48.98 | $54.95 | $95.50 |
Medica Setting Professional Modifier None Typical Low $25.70 Median $47.86 Typical High $398.11 | Professional | None | $25.70 | $47.86 | $398.11 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $12.02 Median $25.70 Typical High $43.65 | Professional | None | $12.02 | $25.70 | $43.65 |
4 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 $24.55 Median $24.55 Typical High $26.92 | Professional | 52 · Reduced service | $24.55 | $24.55 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.00 Typical High $10.72 | Professional | 53 · Discontinued | $9.77 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.41 Typical High $7.94 | Professional | 55 · Aftercare only | $7.24 | $7.41 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.01 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.79 | $5.01 | $5.37 |
Where Oklahoma sits
The same service costs 2.8 times more in Montana than in Ohio. 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· 25th of 51
$48.98
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.