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 $269.15 Median $346.74 Typical High $389.05 | Professional | None | $269.15 | $346.74 | $389.05 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $6,760.83 Median $11,220.18 Typical High $17,378.01 | Facility | None | $6,760.83 | $11,220.18 | $17,378.01 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $323.59 Typical High $1,122.02 | Facility | None | $269.15 | $323.59 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $478.63 | Professional | None | $316.23 | $380.19 | $478.63 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $549.54 Typical High $5,495.41 | Facility | None | $346.74 | $549.54 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $1,949.84 Typical High $2,754.23 | Professional | None | $338.84 | $1,949.84 | $2,754.23 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $6,309.57 | Facility | None | $933.25 | $2,951.21 | $6,309.57 |
United Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $478.63 | Professional | None | $239.88 | $331.13 | $478.63 |
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 $134.90 Median $134.90 Typical High $190.55 | Professional | 52 · Reduced service | $134.90 | $134.90 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $77.62 | Professional | 53 · Discontinued | $53.70 | $53.70 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $288.40 | Professional | 54 · Surgery only | $204.17 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $57.54 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $38.90 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $269.15 |
Where Oklahoma sits
The same service costs 5.2 times more in Alaska than in Texas. 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· 23rd of 51
$437
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.