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 $302.00 Median $1,445.44 Typical High $6,606.93 | Facility | None | $302.00 | $1,445.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $323.59 | Professional | None | $223.87 | $281.84 | $323.59 |
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 $213.80 Median $295.12 Typical High $371.54 | Professional | None | $213.80 | $295.12 | $371.54 |
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 $234.42 Median $288.40 Typical High $363.08 | Professional | None | $234.42 | $288.40 | $363.08 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $389.05 Typical High $2,754.23 | Facility | None | $269.15 | $389.05 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $1,698.24 Typical High $2,089.30 | Professional | None | $245.47 | $1,698.24 | $2,089.30 |
United Setting Facility Modifier None Typical Low $269.15 Median $1,258.93 Typical High $2,511.89 | Facility | None | $269.15 | $1,258.93 | $2,511.89 |
United Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $354.81 | Professional | None | $199.53 | $257.04 | $354.81 |
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 $112.20 Median $112.20 Typical High $141.25 | Professional | 52 · Reduced service | $112.20 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $45.71 Typical High $57.54 | Professional | 53 · Discontinued | $44.67 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $213.80 | Professional | 54 · Surgery only | $169.82 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $42.66 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.91 Typical High $28.18 | Professional | 56 · Pre-op care only | $22.39 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $199.53 |
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· 16th of 51
$363
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.