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 $831.76 Median $3,090.30 Typical High $8,317.64 | Facility | None | $831.76 | $3,090.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $741.31 | Professional | None | $616.60 | $645.65 | $741.31 |
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 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $933.25 | Professional | None | $676.08 | $776.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $724.44 Typical High $891.25 | Facility | None | $512.86 | $724.44 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $870.96 | Professional | None | $616.60 | $724.44 | $870.96 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $1,000.00 Typical High $4,168.69 | Facility | None | $537.03 | $1,000.00 | $4,168.69 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $4,365.16 Typical High $5,248.07 | Professional | None | $588.84 | $4,365.16 | $5,248.07 |
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 $489.78 Median $630.96 Typical High $870.96 | Professional | None | $489.78 | $630.96 | $870.96 |
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 $309.03 Median $309.03 Typical High $371.54 | Professional | 52 · Reduced service | $309.03 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $147.91 | Professional | 53 · Discontinued | $123.03 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $549.54 | Professional | 54 · Surgery only | $457.09 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $109.65 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $74.13 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $512.86 |
Where Oklahoma sits
The same service costs 5.6 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· 26th of 51
$813
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.