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 $288.40 Median $1,445.44 Typical High $6,606.93 | Facility | None | $288.40 | $1,445.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $346.74 | Professional | None | $194.98 | $288.40 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $346.74 Typical High $398.11 | Professional | None | $190.55 | $346.74 | $398.11 |
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 $199.53 Median $295.12 Typical High $407.38 | Professional | None | $199.53 | $295.12 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $229.09 Typical High $263.03 | Facility | None | $66.07 | $229.09 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $371.54 | Professional | None | $223.87 | $302.00 | $371.54 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $398.11 Typical High $1,412.54 | Facility | None | $95.50 | $398.11 | $1,412.54 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $1,479.11 Typical High $2,344.23 | Professional | None | $263.03 | $1,479.11 | $2,344.23 |
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 $177.83 Median $257.04 Typical High $371.54 | Professional | None | $177.83 | $257.04 | $371.54 |
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 $97.72 Median $100.00 Typical High $158.49 | Professional | 52 · Reduced service | $97.72 | $100.00 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $63.10 | Professional | 53 · Discontinued | $39.81 | $39.81 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $234.42 | Professional | 54 · Surgery only | $147.91 | $147.91 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $30.20 Typical High $47.86 | Professional | 55 · Aftercare only | $29.51 | $30.20 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.95 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.50 | $19.95 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $138.04 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $138.04 | $138.04 | $218.78 |
Where Oklahoma sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$355
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.