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 $239.88 Median $302.00 Typical High $389.05 | Professional | None | $239.88 | $302.00 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $251.19 Median $812.83 Typical High $1,412.54 | Facility | None | $251.19 | $812.83 | $1,412.54 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $512.86 | Professional | None | $234.42 | $371.54 | $512.86 |
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 $257.04 Median $363.08 Typical High $457.09 | Professional | None | $257.04 | $363.08 | $457.09 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $512.86 Typical High $1,698.24 | Facility | None | $114.82 | $512.86 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $1,778.28 Typical High $2,884.03 | Professional | None | $338.84 | $1,778.28 | $2,884.03 |
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 $213.80 Median $323.59 Typical High $457.09 | Professional | None | $213.80 | $323.59 | $457.09 |
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 $120.23 Median $120.23 Typical High $194.98 | Professional | 52 · Reduced service | $120.23 | $120.23 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $48.98 Typical High $77.62 | Professional | 53 · Discontinued | $47.86 | $48.98 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $295.12 | Professional | 54 · Surgery only | $181.97 | $181.97 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $58.88 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $24.55 Typical High $38.90 | Professional | 56 · Pre-op care only | $23.99 | $24.55 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $169.82 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $169.82 | $169.82 | $275.42 |
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· 15th of 51
$437
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.