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 $91.20 Median $104.71 Typical High $125.89 | Professional | None | $91.20 | $104.71 | $125.89 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $3,467.37 Median $5,754.40 Typical High $8,912.51 | Facility | None | $3,467.37 | $5,754.40 | $8,912.51 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $154.88 | Professional | None | $83.18 | $114.82 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $93.33 Typical High $125.89 | Facility | None | $66.07 | $93.33 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $147.91 | Professional | None | $107.15 | $131.83 | $147.91 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $158.49 Typical High $3,467.37 | Facility | None | $120.23 | $158.49 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $676.08 Typical High $1,445.44 | Professional | None | $100.00 | $676.08 | $1,445.44 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,041.74 Typical High $3,890.45 | Facility | None | $467.74 | $2,041.74 | $3,890.45 |
United Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $144.54 | Professional | None | $75.86 | $104.71 | $144.54 |
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 $45.71 Median $45.71 Typical High $63.10 | Professional | 52 · Reduced service | $45.71 | $45.71 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $25.12 | Professional | 53 · Discontinued | $18.20 | $18.20 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $93.33 | Professional | 54 · Surgery only | $69.18 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $19.05 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $64.57 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $64.57 | $64.57 | $87.10 |
Where Oklahoma sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 29th of 51
$138
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.