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 $169.82 Median $218.78 Typical High $269.15 | Professional | None | $169.82 | $218.78 | $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 $186.21 Median $263.03 Typical High $426.58 | Professional | None | $186.21 | $263.03 | $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 $194.98 Median $245.47 Typical High $302.00 | Professional | None | $194.98 | $245.47 | $302.00 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $354.81 Typical High $3,801.89 | Facility | None | $234.42 | $354.81 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $1,230.27 Typical High $1,905.46 | Professional | None | $229.09 | $1,230.27 | $1,905.46 |
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 $144.54 Median $213.80 Typical High $309.03 | Professional | None | $144.54 | $213.80 | $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 $85.11 Median $85.11 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $85.11 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $53.70 | Professional | 53 · Discontinued | $33.88 | $33.88 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $204.17 | Professional | 54 · Surgery only | $128.82 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $40.74 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $120.23 | $120.23 | $190.55 |
Where Oklahoma sits
The same service costs 3.7 times more in Alaska than in Utah. 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· 17th of 51
$302
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.