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 $489.78 Median $2,818.38 Typical High $8,317.64 | Facility | None | $489.78 | $2,818.38 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $371.54 Typical High $380.19 | Professional | None | $213.80 | $371.54 | $380.19 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $245.47 Median $831.76 Typical High $1,412.54 | Facility | None | $245.47 | $831.76 | $1,412.54 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $213.80 Median $363.08 Typical High $501.19 | Professional | None | $213.80 | $363.08 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $489.78 Typical High $645.65 | Facility | None | $416.87 | $489.78 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $446.68 | Professional | None | $239.88 | $281.84 | $446.68 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $489.78 Typical High $1,659.59 | Facility | None | $114.82 | $489.78 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $1,584.89 Typical High $2,818.38 | Professional | None | $316.23 | $1,584.89 | $2,818.38 |
United Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $1,548.82 | Facility | None | $89.13 | $616.60 | $1,548.82 |
United Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $436.52 | Professional | None | $190.55 | $302.00 | $436.52 |
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 $107.15 Median $107.15 Typical High $190.55 | Professional | 52 · Reduced service | $107.15 | $107.15 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $75.86 | Professional | 53 · Discontinued | $42.66 | $42.66 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $162.18 Typical High $288.40 | Professional | 54 · Surgery only | $158.49 | $162.18 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $32.36 Typical High $57.54 | Professional | 55 · Aftercare only | $31.62 | $32.36 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $38.02 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $151.36 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $147.91 | $151.36 | $269.15 |
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· 11th of 51
$447
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.