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 $52.48 Median $3,890.45 Typical High $18,620.87 | Facility | None | $52.48 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $50.12 Typical High $52.48 | Professional | None | $48.98 | $50.12 | $52.48 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $46.77 Median $63.10 Typical High $75.86 | Professional | None | $46.77 | $63.10 | $75.86 |
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 $52.48 Median $56.23 Typical High $67.61 | Professional | None | $52.48 | $56.23 | $67.61 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $70.79 Typical High $1,174.90 | Facility | None | $54.95 | $70.79 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $45.71 Median $363.08 Typical High $389.05 | Professional | None | $45.71 | $363.08 | $389.05 |
United Setting Facility Modifier None Typical Low $85.11 Median $575.44 Typical High $1,380.38 | Facility | None | $85.11 | $575.44 | $1,380.38 |
United Setting Professional Modifier None Typical Low $40.74 Median $51.29 Typical High $74.13 | Professional | None | $40.74 | $51.29 | $74.13 |
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 $24.55 Median $24.55 Typical High $26.30 | Professional | 52 · Reduced service | $24.55 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.00 Typical High $10.47 | Professional | 53 · Discontinued | $9.77 | $10.00 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $37.15 Typical High $39.81 | Professional | 54 · Surgery only | $37.15 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.94 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.01 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.90 | $5.01 | $5.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $34.67 Median $34.67 Typical High $37.15 | Professional | 78 · Unplanned return to OR | $34.67 | $34.67 | $37.15 |
Where Oklahoma sits
The same service costs 4.6 times more in Alaska than in New York. 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· 21st of 51
$63.10
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.