How much rates vary
Facilitymedian $3,981 · 10th to 90th $562 to $8,710Professionalmedian $407 · 10th to 90th $288 to $2,138
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 $295.12 Median $407.38 Typical High $512.86 | Professional | None | $295.12 | $407.38 | $512.86 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,288.25 Median $5,623.41 Typical High $9,772.37 | Facility | None | $1,288.25 | $5,623.41 | $9,772.37 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $537.03 | Professional | None | $281.84 | $389.05 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,380.38 Typical High $1,659.59 | Facility | None | $512.86 | $1,380.38 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $489.78 | Professional | None | $309.03 | $407.38 | $489.78 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $6,025.60 | Facility | None | $407.38 | $588.84 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $2,137.96 Typical High $3,019.95 | Professional | None | $363.08 | $2,137.96 | $3,019.95 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $6,309.57 | Facility | None | $933.25 | $2,951.21 | $6,309.57 |
United Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $489.78 | Professional | None | $257.04 | $354.81 | $489.78 |
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 $144.54 Median $147.91 Typical High $204.17 | Professional | 52 · Reduced service | $144.54 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | 53 · Discontinued | $58.88 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $309.03 | Professional | 54 · Surgery only | $218.78 | $218.78 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $44.67 Typical High $61.66 | Professional | 55 · Aftercare only | $43.65 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $40.74 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $204.17 | $204.17 | $288.40 |
Where Oklahoma sits
The same service costs 6.1 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $6,346MT $1,043
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.