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 $218.78 Median $1,445.44 Typical High $6,760.83 | Facility | None | $218.78 | $1,445.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $251.19 | Professional | None | $154.88 | $204.17 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $181.97 | Professional | None | $87.10 | $87.10 | $181.97 |
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 $154.88 Median $204.17 Typical High $269.15 | Professional | None | $154.88 | $204.17 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $162.18 Typical High $467.74 | Facility | None | $138.04 | $162.18 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $257.04 | Professional | None | $158.49 | $194.98 | $257.04 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $295.12 Typical High $4,073.80 | Facility | None | $208.93 | $295.12 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $1,174.90 Typical High $1,548.82 | Professional | None | $177.83 | $1,174.90 | $1,548.82 |
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 $138.04 Median $177.83 Typical High $245.47 | Professional | None | $138.04 | $177.83 | $245.47 |
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 $77.62 Median $77.62 Typical High $102.33 | Professional | 52 · Reduced service | $77.62 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $40.74 | Professional | 53 · Discontinued | $30.90 | $30.90 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $117.49 Typical High $154.88 | Professional | 54 · Surgery only | $114.82 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.44 Typical High $30.90 | Professional | 55 · Aftercare only | $22.91 | $23.44 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $109.65 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $107.15 | $109.65 | $144.54 |
Where Oklahoma sits
The same service costs 4.0 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· 17th of 51
$251
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.