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 $223.87 Median $1,778.28 Typical High $6,760.83 | Facility | None | $223.87 | $1,778.28 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $275.42 | Professional | None | $162.18 | $223.87 | $275.42 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,949.84 Median $3,162.28 Typical High $4,897.79 | Facility | None | $1,949.84 | $3,162.28 | $4,897.79 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $346.74 | Professional | None | $186.21 | $257.04 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,000.00 | Facility | None | $407.38 | $812.83 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $309.03 | Professional | None | $186.21 | $229.09 | $309.03 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $363.08 Typical High $3,801.89 | Facility | None | $204.17 | $363.08 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $1,174.90 Typical High $1,995.26 | Professional | None | $229.09 | $1,174.90 | $1,995.26 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,041.74 Typical High $3,981.07 | Facility | None | $467.74 | $2,041.74 | $3,981.07 |
United Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $309.03 | Professional | None | $138.04 | $218.78 | $309.03 |
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 $81.28 Median $81.28 Typical High $138.04 | Professional | 52 · Reduced service | $81.28 | $81.28 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $54.95 | Professional | 53 · Discontinued | $32.36 | $32.36 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $208.93 | Professional | 54 · Surgery only | $123.03 | $123.03 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $41.69 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $114.82 | $114.82 | $194.98 |
Where Oklahoma sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 16th of 51
$309
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.