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 $630.96 Median $2,511.89 Typical High $7,585.78 | Facility | None | $630.96 | $2,511.89 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $83.18 | Professional | None | $57.54 | $83.18 | $83.18 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $131.83 | Professional | None | $66.07 | $91.20 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $724.44 | Facility | None | $56.23 | $66.07 | $724.44 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $295.12 Typical High $1,174.90 | Facility | None | $75.86 | $295.12 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $758.58 | Professional | None | $93.33 | $158.49 | $758.58 |
United Setting Facility Modifier None Typical Low $89.13 Median $575.44 Typical High $1,380.38 | Facility | None | $89.13 | $575.44 | $1,380.38 |
United Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $144.54 | Professional | None | $60.26 | $93.33 | $144.54 |
5 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 $28.84 Median $33.11 Typical High $41.69 | Professional | 52 · Reduced service | $28.84 | $33.11 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $13.18 Typical High $16.98 | Professional | 53 · Discontinued | $11.48 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $50.12 Typical High $63.10 | Professional | 54 · Surgery only | $42.66 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.00 Typical High $12.59 | Professional | 55 · Aftercare only | $8.51 | $10.00 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.61 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.75 | $6.61 | $8.32 |
Where Oklahoma sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 25th of 51
$120
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.