How much rates vary
Facilitymedian $8,511 · 10th to 90th $933 to $18,197Professionalmedian $813 · 10th to 90th $603 to $5,012
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 $933.25 Median $3,801.89 Typical High $12,589.25 | Facility | None | $933.25 | $3,801.89 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $933.25 | Professional | None | $707.95 | $707.95 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $2,511.89 Median $11,481.54 Typical High $19,952.62 | Facility | None | $2,511.89 | $11,481.54 | $19,952.62 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $870.96 | Professional | None | $645.65 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $5,888.44 | Facility | None | $630.96 | $5,011.87 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $977.24 | Professional | None | $676.08 | $812.83 | $977.24 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $15,848.93 | Facility | None | $933.25 | $2,951.21 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $5,011.87 | Professional | None | $588.84 | $831.76 | $5,011.87 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $7,762.47 Typical High $15,135.61 | Facility | None | $1,905.46 | $7,762.47 | $15,135.61 |
United Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,000.00 | Professional | None | $562.34 | $691.83 | $1,000.00 |
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 $354.81 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $489.78 |
Where Oklahoma sits
The same service costs 6.4 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $13,816MT $2,168
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.