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 $354.81 Median $1,513.56 Typical High $12,589.25 | Facility | None | $354.81 | $1,513.56 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $407.38 | Professional | None | $245.47 | $354.81 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $457.09 Median $2,137.96 Typical High $3,715.35 | Facility | None | $457.09 | $2,137.96 | $3,715.35 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $524.81 | Professional | None | $239.88 | $380.19 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $501.19 Typical High $758.58 | Facility | None | $416.87 | $501.19 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $457.09 | Professional | None | $263.03 | $389.05 | $457.09 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $537.03 Typical High $1,659.59 | Facility | None | $120.23 | $537.03 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $1,819.70 Typical High $2,951.21 | Professional | None | $354.81 | $1,819.70 | $2,951.21 |
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 $218.78 Median $338.84 Typical High $478.63 | Professional | None | $218.78 | $338.84 | $478.63 |
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 $123.03 Median $123.03 Typical High $199.53 | Professional | 52 · Reduced service | $123.03 | $123.03 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $50.12 Typical High $79.43 | Professional | 53 · Discontinued | $48.98 | $50.12 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $302.00 | Professional | 54 · Surgery only | $186.21 | $186.21 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $60.26 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $39.81 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $281.84 |
Where Oklahoma sits
The same service costs 3.3 times more in Alaska than in Utah. 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· 16th of 51
$457
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.