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 $109.65 Median $1,621.81 Typical High $6,760.83 | Facility | None | $109.65 | $1,621.81 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $144.54 Typical High $208.93 | Professional | None | $70.79 | $144.54 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $457.09 Median $602.56 Typical High $851.14 | Facility | None | $457.09 | $602.56 | $851.14 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $75.86 Median $186.21 Typical High $257.04 | Professional | None | $75.86 | $186.21 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $169.82 Typical High $234.42 | Professional | None | $87.10 | $169.82 | $234.42 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $218.78 Typical High $1,548.82 | Facility | None | $100.00 | $218.78 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $741.31 Typical High $2,511.89 | Professional | None | $173.78 | $741.31 | $2,511.89 |
United Setting Facility Modifier None Typical Low $165.96 Median $891.25 Typical High $1,548.82 | Facility | None | $165.96 | $891.25 | $1,548.82 |
United Setting Professional Modifier None Typical Low $69.18 Median $141.25 Typical High $263.03 | Professional | None | $69.18 | $141.25 | $263.03 |
5 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 $38.90 Median $61.66 Typical High $104.71 | Professional | 52 · Reduced service | $38.90 | $61.66 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $24.55 Typical High $41.69 | Professional | 53 · Discontinued | $15.49 | $24.55 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $93.33 Typical High $154.88 | Professional | 54 · Surgery only | $57.54 | $93.33 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $18.62 Typical High $30.90 | Professional | 55 · Aftercare only | $11.75 | $18.62 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $12.30 Typical High $20.89 | Professional | 56 · Pre-op care only | $7.76 | $12.30 | $20.89 |
Where Oklahoma sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 11th of 51
$209
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.