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 $645.65 Median $2,818.38 Typical High $8,317.64 | Facility | None | $645.65 | $2,818.38 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $478.63 | Professional | None | $323.59 | $398.11 | $478.63 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,202.26 Median $5,623.41 Typical High $9,772.37 | Facility | None | $1,202.26 | $5,623.41 | $9,772.37 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $602.56 | Professional | None | $302.00 | $446.68 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $812.83 Typical High $1,000.00 | Facility | None | $512.86 | $812.83 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $537.03 | Professional | None | $380.19 | $457.09 | $537.03 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $660.69 Typical High $4,073.80 | Facility | None | $446.68 | $660.69 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $2,344.23 Typical High $3,388.44 | Professional | None | $416.87 | $2,344.23 | $3,388.44 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,041.74 Typical High $3,981.07 | Facility | None | $467.74 | $2,041.74 | $3,981.07 |
United Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $562.34 | Professional | None | $275.42 | $389.05 | $562.34 |
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 $162.18 Median $162.18 Typical High $239.88 | Professional | 52 · Reduced service | $162.18 | $162.18 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $95.50 | Professional | 53 · Discontinued | $64.57 | $64.57 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $354.81 | Professional | 54 · Surgery only | $245.47 | $245.47 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $70.79 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $47.86 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $331.13 |
Where Oklahoma sits
The same service costs 4.9 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· 22nd of 51
$525
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.