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 $501.19 Median $2,511.89 Typical High $7,585.78 | Facility | None | $501.19 | $2,511.89 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $66.07 Typical High $83.18 | Professional | None | $53.70 | $66.07 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $75.86 | Professional | None | $57.54 | $75.86 | $75.86 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $549.54 Median $912.01 Typical High $1,412.54 | Facility | None | $549.54 | $912.01 | $1,412.54 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $51.29 Median $69.18 Typical High $85.11 | Professional | None | $51.29 | $69.18 | $85.11 |
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 $57.54 Median $75.86 Typical High $87.10 | Professional | None | $57.54 | $75.86 | $87.10 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $112.20 Typical High $1,174.90 | Facility | None | $66.07 | $112.20 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $416.87 Typical High $501.19 | Professional | None | $56.23 | $416.87 | $501.19 |
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 $46.77 Median $60.26 Typical High $87.10 | Professional | None | $46.77 | $60.26 | $87.10 |
7 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 $26.92 Median $26.92 Typical High $33.11 | Professional | 52 · Reduced service | $26.92 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.96 Typical High $13.49 | Professional | 53 · Discontinued | $10.72 | $10.96 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $40.74 Typical High $50.12 | Professional | 54 · Surgery only | $40.74 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $10.00 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.50 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.37 | $5.50 | $6.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.02 Median $38.02 Typical High $46.77 | Professional | 78 · Unplanned return to OR | $38.02 | $38.02 | $46.77 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $47.86 Median $56.23 Typical High $79.43 | Professional | 59 · Distinct service | $47.86 | $56.23 | $79.43 |
Where Oklahoma sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 26th of 51
$77.62
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.