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 $275.42 Median $1,621.81 Typical High $6,760.83 | Facility | None | $275.42 | $1,621.81 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $338.84 | Professional | None | $190.55 | $275.42 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $218.78 | Professional | None | $120.23 | $173.78 | $218.78 |
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 $190.55 Median $263.03 Typical High $363.08 | Professional | None | $190.55 | $263.03 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $213.80 Typical High $467.74 | Facility | None | $177.83 | $213.80 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $323.59 | Professional | None | $173.78 | $275.42 | $323.59 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $389.05 Typical High $2,691.53 | Facility | None | $257.04 | $389.05 | $2,691.53 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $1,445.44 Typical High $2,089.30 | Professional | None | $245.47 | $1,445.44 | $2,089.30 |
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 $165.96 Median $239.88 Typical High $338.84 | Professional | None | $165.96 | $239.88 | $338.84 |
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 $95.50 Median $95.50 Typical High $138.04 | Professional | 52 · Reduced service | $95.50 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.90 Typical High $56.23 | Professional | 53 · Discontinued | $38.02 | $38.90 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $208.93 | Professional | 54 · Surgery only | $144.54 | $144.54 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $41.69 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.50 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.05 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $134.90 | $134.90 | $194.98 |
Where Oklahoma sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 15th of 51
$331
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.