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 $630.96 Median $2,511.89 Typical High $7,585.78 | Facility | None | $630.96 | $2,511.89 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $100.00 | Professional | None | $69.18 | $97.72 | $100.00 |
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 $67.61 Median $93.33 Typical High $128.82 | Professional | None | $67.61 | $93.33 | $128.82 |
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 $75.86 Median $104.71 Typical High $114.82 | Professional | None | $75.86 | $104.71 | $114.82 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $128.82 Typical High $1,174.90 | Facility | None | $83.18 | $128.82 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $524.81 Typical High $741.31 | Professional | None | $85.11 | $524.81 | $741.31 |
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 $61.66 Median $83.18 Typical High $117.49 | Professional | None | $61.66 | $83.18 | $117.49 |
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 $34.67 Median $35.48 Typical High $50.12 | Professional | 52 · Reduced service | $34.67 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.13 Typical High $19.95 | Professional | 53 · Discontinued | $13.80 | $14.13 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $52.48 Typical High $74.13 | Professional | 54 · Surgery only | $52.48 | $52.48 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $14.79 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.08 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.92 | $7.08 | $10.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $48.98 Typical High $69.18 | Professional | 78 · Unplanned return to OR | $48.98 | $48.98 | $69.18 |
Where Oklahoma sits
The same service costs 3.8 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· 16th of 51
$117
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.