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 $630.96 Median $2,511.89 Typical High $7,585.78 | Facility | None | $630.96 | $2,511.89 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $251.19 | Professional | None | $165.96 | $245.47 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $151.36 | Professional | None | $104.71 | $151.36 | $151.36 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $467.74 Median $2,754.23 Typical High $4,786.30 | Facility | None | $467.74 | $2,754.23 | $4,786.30 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $331.13 | Professional | None | $165.96 | $239.88 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $199.53 Typical High $467.74 | Facility | None | $169.82 | $199.53 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $281.84 | Professional | None | $177.83 | $251.19 | $281.84 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $354.81 Typical High $2,630.27 | Facility | None | $234.42 | $354.81 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $1,258.93 Typical High $1,905.46 | Professional | None | $223.87 | $1,258.93 | $1,905.46 |
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 $147.91 Median $218.78 Typical High $309.03 | Professional | None | $147.91 | $218.78 | $309.03 |
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 $83.18 Median $85.11 Typical High $125.89 | Professional | 52 · Reduced service | $83.18 | $85.11 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.88 Typical High $50.12 | Professional | 53 · Discontinued | $33.11 | $33.88 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $190.55 | Professional | 54 · Surgery only | $125.89 | $125.89 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $38.02 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.98 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.60 | $16.98 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $117.49 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $117.49 | $117.49 | $177.83 |
Where Oklahoma sits
The same service costs 3.4 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· 17th 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.