How much rates vary
Facilitymedian $5,623 · 10th to 90th $692 to $14,791Professionalmedian $562 · 10th to 90th $437 to $3,162
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 $676.08 Median $2,818.38 Typical High $8,317.64 | Facility | None | $676.08 | $2,818.38 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
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 $457.09 Median $602.56 Typical High $616.60 | Professional | None | $457.09 | $602.56 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,981.07 Typical High $4,677.35 | Facility | None | $512.86 | $3,981.07 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $741.31 | Professional | None | $512.86 | $575.44 | $741.31 |
Medica Setting Facility Modifier None Typical Low $676.08 Median $1,202.26 Typical High $6,165.95 | Facility | None | $676.08 | $1,202.26 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $4,466.84 | Professional | None | $416.87 | $562.34 | $4,466.84 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $6,309.57 | Facility | None | $933.25 | $3,162.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $724.44 | Professional | None | $389.05 | $501.19 | $724.44 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $346.74 |
Where Oklahoma sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.