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 $223.87 Median $1,445.44 Typical High $6,606.93 | Facility | None | $223.87 | $1,445.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $263.03 | Professional | None | $162.18 | $218.78 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $707.95 Median $2,754.23 Typical High $4,786.30 | Facility | None | $707.95 | $2,754.23 | $4,786.30 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $295.12 | Professional | None | $158.49 | $213.80 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,000.00 | Facility | None | $407.38 | $812.83 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $269.15 | Professional | None | $158.49 | $208.93 | $269.15 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $302.00 Typical High $3,981.07 | Facility | None | $223.87 | $302.00 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $1,230.27 Typical High $1,659.59 | Professional | None | $194.98 | $1,230.27 | $1,659.59 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,041.74 Typical High $3,981.07 | Facility | None | $467.74 | $2,041.74 | $3,981.07 |
United Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $263.03 | Professional | None | $141.25 | $190.55 | $263.03 |
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 $81.28 Median $81.28 Typical High $112.20 | Professional | 52 · Reduced service | $81.28 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.11 Typical High $44.67 | Professional | 53 · Discontinued | $32.36 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | 54 · Surgery only | $123.03 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $114.82 | $114.82 | $158.49 |
Where Oklahoma sits
The same service costs 4.6 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· 19th of 51
$282
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.