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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | None | $60.26 | $66.07 | $66.07 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $67.61 Typical High $120.23 | Facility | None | $60.26 | $67.61 | $120.23 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $58.88 Typical High $467.74 | Professional | None | $32.36 | $58.88 | $467.74 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $15.14 Median $32.36 Typical High $54.95 | Professional | None | $15.14 | $32.36 | $54.95 |
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 $30.20 Median $32.36 Typical High $33.11 | Professional | 52 · Reduced service | $30.20 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.88 Typical High $13.18 | Professional | 53 · Discontinued | $12.02 | $12.88 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.77 Typical High $10.00 | Professional | 55 · Aftercare only | $9.12 | $9.77 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.46 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.03 | $6.46 | $6.61 |
Where Oklahoma sits
The same service costs 2.7 times more in Hawaii than in Utah. 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
$57.54
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.