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 $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $12.30 | Professional | None | $11.22 | $11.22 | $12.30 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Medica Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $22.39 | Facility | None | $10.23 | $10.23 | $22.39 |
Medica Setting Professional Modifier None Typical Low $5.13 Median $10.96 Typical High $81.28 | Professional | None | $5.13 | $10.96 | $81.28 |
United Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
United Setting Professional Modifier None Typical Low $3.98 Median $5.13 Typical High $8.91 | Professional | None | $3.98 | $5.13 | $8.91 |
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 $5.62 Median $5.62 Typical High $6.17 | Professional | 52 · Reduced service | $5.62 | $5.62 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $2.45 | Professional | 53 · Discontinued | $2.24 | $2.24 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $1.86 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.23 |
Where Oklahoma sits
The same service costs 2.7 times more in Montana 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· 26th of 51
$9.77
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.