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 $194.98 Median $1,348.96 Typical High $6,606.93 | Facility | None | $194.98 | $1,348.96 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $229.09 | Professional | None | $144.54 | $190.55 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $141.25 Median $186.21 Typical High $251.19 | Professional | None | $141.25 | $186.21 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $158.49 Typical High $467.74 | Facility | None | $134.90 | $158.49 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $239.88 | Professional | None | $154.88 | $190.55 | $239.88 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $257.04 Typical High $2,691.53 | Facility | None | $194.98 | $257.04 | $2,691.53 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $1,096.48 Typical High $1,445.44 | Professional | None | $165.96 | $1,096.48 | $1,445.44 |
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 $125.89 Median $165.96 Typical High $229.09 | Professional | None | $125.89 | $165.96 | $229.09 |
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 $72.44 Median $72.44 Typical High $95.50 | Professional | 52 · Reduced service | $72.44 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | 53 · Discontinued | $28.84 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $109.65 Typical High $144.54 | Professional | 54 · Surgery only | $107.15 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.88 Typical High $28.84 | Professional | 55 · Aftercare only | $21.38 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $19.50 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $102.33 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $100.00 | $102.33 | $134.90 |
Where Oklahoma sits
The same service costs 3.9 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· 18th of 51
$229
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.