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 $75.86 Median $131.83 Typical High $165.96 | Professional | None | $75.86 | $131.83 | $165.96 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $74.13 Median $158.49 Typical High $218.78 | Professional | None | $74.13 | $158.49 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $213.80 | Professional | None | $91.20 | $134.90 | $213.80 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $218.78 Typical High $1,548.82 | Facility | None | $104.71 | $218.78 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $616.60 Typical High $1,737.80 | Professional | None | $169.82 | $616.60 | $1,737.80 |
United Setting Facility Modifier None Typical Low $165.96 Median $891.25 Typical High $1,548.82 | Facility | None | $165.96 | $891.25 | $1,548.82 |
United Setting Professional Modifier None Typical Low $72.44 Median $138.04 Typical High $229.09 | Professional | None | $72.44 | $138.04 | $229.09 |
5 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 $38.02 Median $57.54 Typical High $83.18 | Professional | 52 · Reduced service | $38.02 | $57.54 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $23.44 Typical High $33.11 | Professional | 53 · Discontinued | $15.49 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $87.10 Typical High $123.03 | Professional | 54 · Surgery only | $57.54 | $87.10 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $17.38 Typical High $25.12 | Professional | 55 · Aftercare only | $11.48 | $17.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $11.48 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.59 | $11.48 | $16.60 |
Where Oklahoma sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 12th of 51
$191
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.