How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,023 to $12,589Professionalmedian $933 · 10th to 90th $676 to $5,888
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 $954.99 Median $3,801.89 Typical High $12,589.25 | Facility | None | $954.99 | $3,801.89 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | None | $831.76 | $831.76 | $1,000.00 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $5,370.32 Median $8,912.51 Typical High $13,803.84 | Facility | None | $5,370.32 | $8,912.51 | $13,803.84 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,148.15 | Professional | None | $758.58 | $1,023.29 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,819.70 Typical High $2,187.76 | Facility | None | $630.96 | $1,819.70 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,047.13 | Professional | None | $741.31 | $933.25 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $8,709.64 | Facility | None | $1,000.00 | $1,584.89 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $5,888.44 | Professional | None | $676.08 | $870.96 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,073.80 Typical High $8,511.38 | Facility | None | $1,230.27 | $4,073.80 | $8,511.38 |
United Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,148.15 | Professional | None | $645.65 | $794.33 | $1,148.15 |
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 $416.87 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
Where Oklahoma sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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
WI $7,619HI $2,493
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.