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 $95.50 Median $1,479.11 Typical High $6,760.83 | Facility | None | $95.50 | $1,479.11 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $134.90 | Professional | None | $64.57 | $95.50 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $131.83 | Professional | None | $77.62 | $107.15 | $131.83 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $181.97 Median $794.33 Typical High $1,348.96 | Facility | None | $181.97 | $794.33 | $1,348.96 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $61.66 Median $104.71 Typical High $144.54 | Professional | None | $61.66 | $104.71 | $144.54 |
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 $70.79 Median $109.65 Typical High $123.03 | Professional | None | $70.79 | $109.65 | $123.03 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $151.36 Typical High $1,479.11 | Facility | None | $75.86 | $151.36 | $1,479.11 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $512.86 Typical High $851.14 | Professional | None | $91.20 | $512.86 | $851.14 |
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 $57.54 Median $91.20 Typical High $128.82 | Professional | None | $57.54 | $91.20 | $128.82 |
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 $32.36 Median $33.11 Typical High $56.23 | Professional | 52 · Reduced service | $32.36 | $33.11 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.18 Typical High $22.39 | Professional | 53 · Discontinued | $12.88 | $13.18 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $83.18 | Professional | 54 · Surgery only | $48.98 | $48.98 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $16.60 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.61 Typical High $11.22 | Professional | 56 · Pre-op care only | $6.46 | $6.61 | $11.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $45.71 Median $45.71 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $45.71 | $45.71 | $77.62 |
Where Oklahoma sits
The same service costs 3.9 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· 17th of 51
$123
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.