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 $102.33 Median $138.04 Typical High $144.54 | Professional | None | $102.33 | $138.04 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $117.49 Typical High $162.18 | Professional | None | $58.88 | $117.49 | $162.18 |
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 $100.00 Median $134.90 Typical High $186.21 | Professional | None | $100.00 | $134.90 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $128.82 Typical High $467.74 | Facility | None | $107.15 | $128.82 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $165.96 | Professional | None | $112.20 | $147.91 | $165.96 |
Medica Setting Facility Modifier None Typical Low $141.25 Median $186.21 Typical High $2,630.27 | Facility | None | $141.25 | $186.21 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $812.83 Typical High $1,071.52 | Professional | None | $123.03 | $812.83 | $1,071.52 |
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 $89.13 Median $120.23 Typical High $165.96 | Professional | None | $89.13 | $120.23 | $165.96 |
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 $51.29 Median $52.48 Typical High $70.79 | Professional | 52 · Reduced service | $51.29 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $28.18 | Professional | 53 · Discontinued | $20.42 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $107.15 | Professional | 54 · Surgery only | $77.62 | $77.62 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $21.38 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.47 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.23 | $10.47 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $72.44 | $72.44 | $100.00 |
Where Oklahoma sits
The same service costs 4.1 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
$170
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.