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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $72.44 | Professional | None | $61.66 | $66.07 | $72.44 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $74.13 Typical High $128.82 | Facility | None | $66.07 | $74.13 | $128.82 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $64.57 Typical High $478.63 | Professional | None | $30.20 | $64.57 | $478.63 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $24.55 Median $30.20 Typical High $52.48 | Professional | None | $24.55 | $30.20 | $52.48 |
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 $30.90 Median $33.11 Typical High $36.31 | Professional | 52 · Reduced service | $30.90 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.18 Typical High $14.45 | Professional | 53 · Discontinued | $12.30 | $13.18 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.77 Typical High $10.72 | Professional | 55 · Aftercare only | $9.12 | $9.77 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.61 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.17 | $6.61 | $7.24 |
Where Oklahoma sits
The same service costs 2.8 times more in Montana than in Alabama. 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· 15th of 51
$64.57
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.