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 $158.49 Median $1,621.81 Typical High $6,760.83 | Facility | None | $158.49 | $1,621.81 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $208.93 | Professional | None | $114.82 | $158.49 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $165.96 | Professional | None | $70.79 | $102.33 | $165.96 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $524.81 Median $2,818.38 Typical High $4,786.30 | Facility | None | $524.81 | $2,818.38 | $4,786.30 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $223.87 | Professional | None | $114.82 | $162.18 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $144.54 Typical High $467.74 | Facility | None | $123.03 | $144.54 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $190.55 | Professional | None | $117.49 | $158.49 | $190.55 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $229.09 Typical High $2,630.27 | Facility | None | $158.49 | $229.09 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $147.91 Median $870.96 Typical High $1,288.25 | Professional | None | $147.91 | $870.96 | $1,288.25 |
United Setting Facility Modifier None Typical Low $269.15 Median $1,148.15 Typical High $2,454.71 | Facility | None | $269.15 | $1,148.15 | $2,454.71 |
United Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $194.98 | Professional | None | $100.00 | $141.25 | $194.98 |
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 $57.54 Median $57.54 Typical High $85.11 | Professional | 52 · Reduced service | $57.54 | $57.54 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $34.67 | Professional | 53 · Discontinued | $22.91 | $22.91 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $87.10 Typical High $128.82 | Professional | 54 · Surgery only | $85.11 | $87.10 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $25.70 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $81.28 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $79.43 | $81.28 | $120.23 |
Where Oklahoma sits
The same service costs 3.8 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
$204
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.