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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $77.62 Typical High $81.28 | Professional | None | $72.44 | $77.62 | $81.28 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $83.18 Typical High $144.54 | Facility | None | $72.44 | $83.18 | $144.54 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $70.79 Typical High $524.81 | Professional | None | $38.90 | $70.79 | $524.81 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $15.14 Median $38.90 Typical High $67.61 | Professional | None | $15.14 | $38.90 | $67.61 |
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 $36.31 Median $38.90 Typical High $39.81 | Professional | 52 · Reduced service | $36.31 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.49 Typical High $16.22 | Professional | 53 · Discontinued | $14.45 | $15.49 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.75 Typical High $12.02 | Professional | 55 · Aftercare only | $10.96 | $11.75 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.76 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.24 | $7.76 | $8.13 |
Where Oklahoma sits
The same service costs 2.3 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· 30th of 51
$67.61
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.