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 $1,202.26 Median $4,466.84 Typical High $12,589.25 | Facility | None | $1,202.26 | $4,466.84 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,089.30 | Professional | None | $1,737.80 | $1,737.80 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $5,011.87 Median $17,378.01 Typical High $30,199.52 | Facility | None | $5,011.87 | $17,378.01 | $30,199.52 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $1,584.89 Median $2,137.96 Typical High $2,238.72 | Professional | None | $1,584.89 | $2,137.96 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,981.07 Typical High $4,677.35 | Facility | None | $630.96 | $3,981.07 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,737.80 | $1,949.84 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $1,737.80 Median $2,511.89 Typical High $14,454.40 | Facility | None | $1,737.80 | $2,511.89 | $14,454.40 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $12,022.64 | Professional | None | $1,479.11 | $1,995.26 | $12,022.64 |
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 $1,380.38 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,737.80 | $2,454.71 |
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 $870.96 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
Where Oklahoma sits
The same service costs 7.8 times more in Alaska than in Texas. 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· 28th of 51
$2,138
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.