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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $19.95 Typical High $19.95 | Professional | None | $18.20 | $19.95 | $19.95 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medica Setting Facility Modifier None Typical Low $18.20 Median $20.42 Typical High $36.31 | Facility | None | $18.20 | $20.42 | $36.31 |
Medica Setting Professional Modifier None Typical Low $8.32 Median $17.78 Typical High $131.83 | Professional | None | $8.32 | $17.78 | $131.83 |
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 $6.03 Median $8.32 Typical High $14.13 | Professional | None | $6.03 | $8.32 | $14.13 |
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 $8.91 Median $9.12 Typical High $10.00 | Professional | 52 · Reduced service | $8.91 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.63 Typical High $3.98 | Professional | 53 · Discontinued | $3.55 | $3.63 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.69 Typical High $3.02 | Professional | 55 · Aftercare only | $2.63 | $2.69 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.82 Typical High $2.00 | Professional | 56 · Pre-op care only | $1.78 | $1.82 | $2.00 |
Where Oklahoma sits
The same service costs 3.2 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· 12th of 51
$17.78
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.