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 $831.76 Median $3,090.30 Typical High $8,317.64 | Facility | None | $831.76 | $3,090.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $234.42 | Professional | None | $177.83 | $234.42 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,047.13 Median $5,623.41 Typical High $9,772.37 | Facility | None | $1,047.13 | $5,623.41 | $9,772.37 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $309.03 | Professional | None | $173.78 | $229.09 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $812.83 Typical High $1,000.00 | Facility | None | $512.86 | $812.83 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $295.12 | Professional | None | $181.97 | $229.09 | $295.12 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $331.13 Typical High $4,073.80 | Facility | None | $239.88 | $331.13 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $1,348.96 Typical High $1,778.28 | Professional | None | $204.17 | $1,348.96 | $1,778.28 |
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 $158.49 Median $204.17 Typical High $288.40 | Professional | None | $158.49 | $204.17 | $288.40 |
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 $89.13 Median $89.13 Typical High $117.49 | Professional | 52 · Reduced service | $89.13 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $46.77 | Professional | 53 · Discontinued | $35.48 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $134.90 Typical High $177.83 | Professional | 54 · Surgery only | $131.83 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.92 Typical High $35.48 | Professional | 55 · Aftercare only | $26.30 | $26.92 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $23.44 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $125.89 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $123.03 | $125.89 | $165.96 |
Where Oklahoma sits
The same service costs 4.7 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
$302
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.