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 $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 $218.78 Median $380.19 Typical High $389.05 | Professional | None | $218.78 | $380.19 | $389.05 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $245.47 Median $812.83 Typical High $1,412.54 | Facility | None | $245.47 | $812.83 | $1,412.54 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $218.78 Median $363.08 Typical High $501.19 | Professional | None | $218.78 | $363.08 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $275.42 Typical High $630.96 | Facility | None | $229.09 | $275.42 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $446.68 | Professional | None | $239.88 | $302.00 | $446.68 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $501.19 Typical High $1,659.59 | Facility | None | $114.82 | $501.19 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $1,621.81 Typical High $2,818.38 | Professional | None | $323.59 | $1,621.81 | $2,818.38 |
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 $194.98 Median $309.03 Typical High $436.52 | Professional | None | $194.98 | $309.03 | $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 $109.65 Median $109.65 Typical High $194.98 | Professional | 52 · Reduced service | $109.65 | $109.65 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $77.62 | Professional | 53 · Discontinued | $43.65 | $43.65 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $165.96 Typical High $288.40 | Professional | 54 · Surgery only | $162.18 | $165.96 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $57.54 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $154.88 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $151.36 | $154.88 | $269.15 |
Where Oklahoma sits
The same service costs 3.5 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· 12th 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.