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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $58.88 | Professional | None | $53.70 | $58.88 | $58.88 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $104.71 | Facility | None | $48.98 | $48.98 | $104.71 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $52.48 Typical High $389.05 | Professional | None | $28.84 | $52.48 | $389.05 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $19.05 Median $28.84 Typical High $50.12 | Professional | None | $19.05 | $28.84 | $50.12 |
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 $26.92 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $26.92 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $10.72 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $7.94 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.37 | $5.89 | $5.89 |
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· 24th of 51
$52.48
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.