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 $54.95 Median $100.00 Typical High $102.33 | Professional | None | $54.95 | $100.00 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $3,019.95 | Facility | None | $1,202.26 | $1,949.84 | $3,019.95 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $131.83 | Professional | None | $67.61 | $97.72 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $72.44 Typical High $100.00 | Facility | None | $58.88 | $72.44 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $117.49 Typical High $169.82 | Professional | None | $66.07 | $117.49 | $169.82 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $190.55 Typical High $1,174.90 | Facility | None | $74.13 | $190.55 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $407.38 Typical High $758.58 | Professional | None | $107.15 | $407.38 | $758.58 |
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 $57.54 Median $89.13 Typical High $154.88 | Professional | None | $57.54 | $89.13 | $154.88 |
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 $27.54 Median $28.18 Typical High $51.29 | Professional | 52 · Reduced service | $27.54 | $28.18 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.22 Typical High $20.42 | Professional | 53 · Discontinued | $10.96 | $11.22 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $41.69 Typical High $75.86 | Professional | 54 · Surgery only | $41.69 | $41.69 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $15.14 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.50 | $5.62 | $10.23 |
Where Oklahoma sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 13th of 51
$132
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.