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 $144.54 Median $1,202.26 Typical High $6,606.93 | Facility | None | $144.54 | $1,202.26 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $177.83 | Professional | None | $102.33 | $144.54 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $144.54 Typical High $169.82 | Professional | None | $57.54 | $144.54 | $169.82 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $169.82 Median $891.25 Typical High $1,513.56 | Facility | None | $169.82 | $891.25 | $1,513.56 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $194.98 | Professional | None | $102.33 | $144.54 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $125.89 Typical High $144.54 | Facility | None | $66.07 | $125.89 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $177.83 | Professional | None | $100.00 | $138.04 | $177.83 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $194.98 Typical High $1,174.90 | Facility | None | $93.33 | $194.98 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $794.33 Typical High $1,122.02 | Professional | None | $131.83 | $794.33 | $1,122.02 |
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 $85.11 Median $123.03 Typical High $173.78 | Professional | None | $85.11 | $123.03 | $173.78 |
6 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 $51.29 Median $51.29 Typical High $74.13 | Professional | 52 · Reduced service | $51.29 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $29.51 | Professional | 53 · Discontinued | $20.42 | $20.42 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $77.62 Typical High $112.20 | Professional | 54 · Surgery only | $75.86 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $22.39 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $72.44 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $70.79 | $72.44 | $104.71 |
Where Oklahoma sits
The same service costs 4.1 times more in Alaska 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· 16th of 51
$178
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.