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 $120.23 Median $1,778.28 Typical High $6,760.83 | Facility | None | $120.23 | $1,778.28 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $331.13 | Professional | None | $87.10 | $128.82 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
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 $87.10 Median $302.00 Typical High $407.38 | Professional | None | $87.10 | $302.00 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $354.81 | Professional | None | $97.72 | $162.18 | $354.81 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $323.59 Typical High $1,548.82 | Facility | None | $109.65 | $323.59 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $1,148.15 Typical High $2,691.53 | Professional | None | $257.04 | $1,148.15 | $2,691.53 |
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 $77.62 Median $186.21 Typical High $426.58 | Professional | None | $77.62 | $186.21 | $426.58 |
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 $43.65 Median $70.79 Typical High $165.96 | Professional | 52 · Reduced service | $43.65 | $70.79 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $28.18 Typical High $66.07 | Professional | 53 · Discontinued | $17.38 | $28.18 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $107.15 Typical High $251.19 | Professional | 54 · Surgery only | $66.07 | $107.15 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $21.38 Typical High $50.12 | Professional | 55 · Aftercare only | $13.18 | $21.38 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $14.13 Typical High $33.11 | Professional | 56 · Pre-op care only | $8.71 | $14.13 | $33.11 |
Where Oklahoma sits
The same service costs 4.2 times more in Washington 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· 9th of 51
$316
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.