How much rates vary
Facilitymedian $8,128 · 10th to 90th $912 to $17,783Professionalmedian $692 · 10th to 90th $513 to $4,365
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 $794.33 Median $3,801.89 Typical High $13,182.57 | Facility | None | $794.33 | $3,801.89 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $660.69 | Professional | None | $602.56 | $602.56 | $660.69 |
Ambetter Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $616.60 | Professional | None | $602.56 | $602.56 | $616.60 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $2,454.71 Median $11,481.54 Typical High $19,952.62 | Facility | None | $2,454.71 | $11,481.54 | $19,952.62 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $758.58 | Professional | None | $549.54 | $741.31 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,819.70 Typical High $2,187.76 | Facility | None | $776.25 | $1,819.70 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $758.58 | Professional | None | $562.34 | $691.83 | $758.58 |
Medica Setting Facility Modifier None Typical Low $794.33 Median $2,818.38 Typical High $14,454.40 | Facility | None | $794.33 | $2,818.38 | $14,454.40 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $4,365.16 | Professional | None | $478.63 | $660.69 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $7,585.78 Typical High $14,454.40 | Facility | None | $1,862.09 | $7,585.78 | $14,454.40 |
United Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $851.14 | Professional | None | $478.63 | $562.34 | $851.14 |
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 $302.00 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $416.87 |
Where Oklahoma sits
The same service costs 4.7 times more in Oklahoma 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
OK $8,820MT $1,888
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.