How much rates vary
Facilitymedian $4,266 · 10th to 90th $562 to $9,333Professionalmedian $324 · 10th to 90th $245 to $3,890
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 $501.19 Median $2,511.89 Typical High $7,585.78 | Facility | None | $501.19 | $2,511.89 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $295.12 | Professional | None | $288.40 | $288.40 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,479.11 Median $5,888.44 Typical High $10,232.93 | Facility | None | $1,479.11 | $5,888.44 | $10,232.93 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $363.08 | Professional | None | $263.03 | $354.81 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,778.28 Typical High $2,089.30 | Facility | None | $407.38 | $1,778.28 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $436.52 | Professional | None | $302.00 | $323.59 | $436.52 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $1,174.90 Typical High $6,165.95 | Facility | None | $398.11 | $1,174.90 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $3,890.45 | Professional | None | $245.47 | $331.13 | $3,890.45 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $6,309.57 | Facility | None | $933.25 | $2,951.21 | $6,309.57 |
United Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $426.58 | Professional | None | $229.09 | $295.12 | $426.58 |
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 $144.54 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $199.53 | $199.53 | $199.53 |
Where Oklahoma sits
The same service costs 7.3 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 $6,269MT $863
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.