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 $162.18 Median $223.87 Typical High $269.15 | Professional | None | $162.18 | $223.87 | $269.15 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,949.84 Median $3,235.94 Typical High $5,011.87 | Facility | None | $1,949.84 | $3,235.94 | $5,011.87 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $426.58 | Professional | None | $181.97 | $257.04 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $229.09 Typical High $467.74 | Facility | None | $190.55 | $229.09 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $295.12 | Professional | None | $186.21 | $245.47 | $295.12 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $363.08 Typical High $2,398.83 | Facility | None | $199.53 | $363.08 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $1,148.15 Typical High $1,905.46 | Professional | None | $223.87 | $1,148.15 | $1,905.46 |
United Setting Facility Modifier None Typical Low $269.15 Median $1,258.93 Typical High $2,511.89 | Facility | None | $269.15 | $1,258.93 | $2,511.89 |
United Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $302.00 | Professional | None | $138.04 | $208.93 | $302.00 |
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 $134.90 | Professional | 52 · Reduced service | $81.28 | $81.28 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $53.70 | Professional | 53 · Discontinued | $32.36 | $32.36 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $199.53 | Professional | 54 · Surgery only | $123.03 | $123.03 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $40.74 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $114.82 | $114.82 | $186.21 |
Where Oklahoma sits
The same service costs 4.4 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
$295
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.