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 $29.51 Median $57.54 Typical High $58.88 | Professional | None | $29.51 | $57.54 | $58.88 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $3,981.07 | Facility | None | $1,513.56 | $2,511.89 | $3,981.07 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $28.84 Median $56.23 Typical High $77.62 | Professional | None | $28.84 | $56.23 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $2,691.53 | Facility | None | $50.12 | $100.00 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $50.12 Typical High $67.61 | Professional | None | $32.36 | $50.12 | $67.61 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $85.11 Typical High $1,174.90 | Facility | None | $41.69 | $85.11 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $1,230.27 Typical High $1,445.44 | Professional | None | $53.70 | $1,230.27 | $1,445.44 |
United Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $1,380.38 | Facility | None | $89.13 | $616.60 | $1,380.38 |
United Setting Professional Modifier None Typical Low $26.30 Median $46.77 Typical High $74.13 | Professional | None | $26.30 | $46.77 | $74.13 |
5 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 $14.79 Median $14.79 Typical High $29.51 | Professional | 52 · Reduced service | $14.79 | $14.79 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $11.75 | Professional | 53 · Discontinued | $5.89 | $5.89 | $11.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $22.39 Typical High $44.67 | Professional | 54 · Surgery only | $21.88 | $22.39 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.47 Typical High $8.91 | Professional | 55 · Aftercare only | $4.37 | $4.47 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $5.89 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $5.89 |
Where Oklahoma sits
The same service costs 4.0 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· 6th of 51
$85.11
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.