How much rates vary
Facilitymedian $1,175 · 10th to 90th $331 to $4,365Professionalmedian $288 · 10th to 90th $214 to $1,820
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 $354.81 Median $2,818.38 Typical High $8,317.64 | Facility | None | $354.81 | $2,818.38 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $316.23 | Professional | None | $234.42 | $309.03 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $977.24 Typical High $1,258.93 | Facility | None | $630.96 | $977.24 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $346.74 | Professional | None | $257.04 | $288.40 | $346.74 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $524.81 Typical High $4,073.80 | Facility | None | $257.04 | $524.81 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $1,819.70 | Professional | None | $213.80 | $288.40 | $1,819.70 |
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 $204.17 Median $257.04 Typical High $338.84 | Professional | None | $204.17 | $257.04 | $338.84 |
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 $125.89 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $25.12 |
Where Oklahoma sits
The same service costs 6.2 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,689MT $752
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.