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 $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
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 $26.92 Median $47.86 Typical High $407.38 | Professional | None | $26.92 | $47.86 | $407.38 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $12.02 Median $26.92 Typical High $46.77 | Professional | None | $12.02 | $26.92 | $46.77 |
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 $23.99 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $23.99 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $9.77 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.94 Typical High $8.13 | Professional | 55 · Aftercare only | $7.24 | $7.94 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.79 | $5.37 | $5.37 |
Where Oklahoma sits
The same service costs 2.8 times more in Montana than in Indiana. 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· 29th of 51
$46.77
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.