How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,000 to $15,136Professionalmedian $851 · 10th to 90th $646 to $7,244
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 $741.31 Median $741.31 Typical High $1,000.00 | Professional | None | $741.31 | $741.31 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $295.12 Typical High $724.44 | Professional | None | $100.00 | $295.12 | $724.44 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $2,344.23 Median $9,120.11 Typical High $15,848.93 | Facility | None | $2,344.23 | $9,120.11 | $15,848.93 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $977.24 | Professional | None | $676.08 | $912.01 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,248.07 Typical High $6,165.95 | Facility | None | $630.96 | $5,248.07 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,047.13 | Professional | None | $741.31 | $851.14 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $3,019.95 Typical High $15,848.93 | Facility | None | $977.24 | $3,019.95 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $7,244.36 | Professional | None | $630.96 | $812.83 | $7,244.36 |
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 $588.84 Median $741.31 Typical High $1,047.13 | Professional | None | $588.84 | $741.31 | $1,047.13 |
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 $371.54 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $524.81 |
Where Oklahoma sits
The same service costs 6.1 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 $13,882MT $2,270
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.