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 $229.09 Median $3,890.45 Typical High $18,620.87 | Facility | None | $229.09 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $229.09 | Professional | None | $131.83 | $223.87 | $229.09 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $309.03 | Professional | None | $125.89 | $223.87 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $125.89 | Facility | None | $50.12 | $75.86 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $251.19 | Professional | None | $144.54 | $213.80 | $251.19 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $323.59 Typical High $1,174.90 | Facility | None | $91.20 | $323.59 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $1,000.00 Typical High $1,698.24 | Professional | None | $208.93 | $1,000.00 | $1,698.24 |
United Setting Facility Modifier None Typical Low $89.13 Median $575.44 Typical High $1,380.38 | Facility | None | $89.13 | $575.44 | $1,380.38 |
United Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $288.40 | Professional | None | $117.49 | $199.53 | $288.40 |
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 $66.07 Median $67.61 Typical High $114.82 | Professional | 52 · Reduced service | $66.07 | $67.61 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $45.71 | Professional | 53 · Discontinued | $26.92 | $26.92 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $173.78 | Professional | 54 · Surgery only | $100.00 | $100.00 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $34.67 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.49 Typical High $22.91 | Professional | 56 · Pre-op care only | $13.18 | $13.49 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $93.33 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $93.33 | $93.33 | $162.18 |
Where Oklahoma sits
The same service costs 3.8 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· 20th of 51
$240
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.