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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $19.05 | Professional | None | $16.98 | $16.98 | $19.05 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Medica Setting Facility Modifier None Typical Low $16.98 Median $19.50 Typical High $33.88 | Facility | None | $16.98 | $19.50 | $33.88 |
Medica Setting Professional Modifier None Typical Low $8.13 Median $16.60 Typical High $123.03 | Professional | None | $8.13 | $16.60 | $123.03 |
United Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
United Setting Professional Modifier None Typical Low $6.61 Median $8.13 Typical High $15.85 | Professional | None | $6.61 | $8.13 | $15.85 |
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 $8.51 Median $8.51 Typical High $9.33 | Professional | 52 · Reduced service | $8.51 | $8.51 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.39 Typical High $3.80 | Professional | 53 · Discontinued | $3.39 | $3.39 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $2.82 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.70 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.70 | $1.70 | $1.91 |
Where Oklahoma sits
The same service costs 3.0 times more in Montana than in New York. 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· 22nd of 51
$16.60
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.