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 $1,000.00 Median $3,981.07 Typical High $12,589.25 | Facility | None | $1,000.00 | $3,981.07 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $331.13 | Professional | None | $295.12 | $295.12 | $331.13 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $4,897.79 Median $8,128.31 Typical High $12,589.25 | Facility | None | $4,897.79 | $8,128.31 | $12,589.25 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $416.87 | Professional | None | $269.15 | $371.54 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $977.24 Typical High $1,174.90 | Facility | None | $630.96 | $977.24 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $426.58 | Professional | None | $338.84 | $380.19 | $426.58 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $691.83 Typical High $5,888.44 | Facility | None | $380.19 | $691.83 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $2,137.96 Typical High $3,090.30 | Professional | None | $281.84 | $2,137.96 | $3,090.30 |
United Setting Facility Modifier None Typical Low $912.01 Median $2,951.21 Typical High $6,025.60 | Facility | None | $912.01 | $2,951.21 | $6,025.60 |
United Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $436.52 | Professional | None | $239.88 | $316.23 | $436.52 |
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 $147.91 Median $147.91 Typical High $162.18 | Professional | 52 · Reduced service | $147.91 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $66.07 | Professional | 53 · Discontinued | $58.88 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $245.47 | Professional | 54 · Surgery only | $218.78 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $48.98 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $33.11 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $204.17 | $204.17 | $229.09 |
Where Oklahoma sits
The same service costs 6.8 times more in Alaska than in Utah. 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· 30th of 51
$380
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.