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 $1,000.00 Median $3,162.28 Typical High $8,317.64 | Facility | None | $1,000.00 | $3,162.28 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $190.55 Median $1,148.15 Typical High $1,905.46 | Facility | None | $190.55 | $1,148.15 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,630.27 Typical High $3,162.28 | Facility | None | $630.96 | $2,630.27 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $2,570.40 Typical High $8,511.38 | Facility | None | $331.13 | $2,570.40 | $8,511.38 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $2,570.40 | Professional | None | $302.00 | $478.63 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,073.80 Typical High $8,511.38 | Facility | None | $1,230.27 | $4,073.80 | $8,511.38 |
United Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $562.34 | Professional | None | $302.00 | $398.11 | $562.34 |
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 $147.91 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $29.51 |
Where Oklahoma sits
The same service costs 28.2 times more in Texas than in Kentucky. 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· 6th of 51
$851
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.