How much rates vary
Facilitymedian $1,622 · 10th to 90th $288 to $5,370Professionalmedian $263 · 10th to 90th $178 to $1,318
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 $263.03 Median $2,818.38 Typical High $8,317.64 | Facility | None | $263.03 | $2,818.38 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $263.03 | Professional | None | $177.83 | $257.04 | $263.03 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $426.58 Median $1,737.80 Typical High $3,019.95 | Facility | None | $426.58 | $1,737.80 | $3,019.95 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $338.84 | Professional | None | $177.83 | $245.47 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,380.38 Typical High $1,659.59 | Facility | None | $512.86 | $1,380.38 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $309.03 | Professional | None | $181.97 | $234.42 | $309.03 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $380.19 Typical High $6,025.60 | Facility | None | $245.47 | $380.19 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $1,318.26 Typical High $1,949.84 | Professional | None | $223.87 | $1,318.26 | $1,949.84 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $6,309.57 | Facility | None | $933.25 | $2,951.21 | $6,309.57 |
United Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $295.12 | Professional | None | $158.49 | $218.78 | $295.12 |
7 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 $89.13 Median $89.13 Typical High $131.83 | Professional | 52 · Reduced service | $89.13 | $89.13 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $52.48 | Professional | 53 · Discontinued | $35.48 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $134.90 Typical High $194.98 | Professional | 54 · Surgery only | $131.83 | $134.90 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.92 Typical High $39.81 | Professional | 55 · Aftercare only | $26.30 | $26.92 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $26.30 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $125.89 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $123.03 | $125.89 | $181.97 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $162.18 |
Where Oklahoma sits
The same service costs 9.3 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $5,912MT $637
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.