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 $81.28 Median $263.03 Typical High $2,570.40 | Professional | None | $81.28 | $263.03 | $2,570.40 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $3,090.30 | Facility | None | $1,202.26 | $1,995.26 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $724.44 Typical High $2,691.53 | Facility | None | $549.54 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $239.88 Typical High $371.54 | Professional | None | $87.10 | $239.88 | $371.54 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $323.59 Typical High $1,174.90 | Facility | None | $85.11 | $323.59 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $831.76 Typical High $1,737.80 | Professional | None | $288.40 | $831.76 | $1,737.80 |
United Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $1,380.38 | Facility | None | $89.13 | $616.60 | $1,380.38 |
United Setting Professional Modifier None Typical Low $79.43 Median $204.17 Typical High $416.87 | Professional | None | $79.43 | $204.17 | $416.87 |
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 $40.74 Median $40.74 Typical High $131.83 | Professional | 52 · Reduced service | $40.74 | $40.74 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $52.48 | Professional | 53 · Discontinued | $16.22 | $16.22 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $61.66 Typical High $199.53 | Professional | 54 · Surgery only | $60.26 | $61.66 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $39.81 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $26.30 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $26.30 |
Where Oklahoma sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 1st of 51
$575
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.