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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $77.62 | Professional | None | $69.18 | $75.86 | $77.62 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $77.62 Typical High $134.90 | Facility | None | $69.18 | $77.62 | $134.90 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $72.44 Typical High $616.60 | Professional | None | $41.69 | $72.44 | $616.60 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $12.02 Median $41.69 Typical High $72.44 | Professional | None | $12.02 | $41.69 | $72.44 |
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 $34.67 Median $38.02 Typical High $38.90 | Professional | 52 · Reduced service | $34.67 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $15.14 Typical High $15.49 | Professional | 53 · Discontinued | $13.80 | $15.14 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.22 Typical High $11.75 | Professional | 55 · Aftercare only | $10.23 | $11.22 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.59 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.92 | $7.59 | $7.76 |
Where Oklahoma sits
The same service costs 2.6 times more in Hawaii 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· 30th of 51
$69.18
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.