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 $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 $213.80 Median $213.80 Typical High $223.87 | Professional | None | $213.80 | $213.80 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $3,090.30 | Facility | None | $1,202.26 | $1,995.26 | $3,090.30 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $281.84 | Professional | None | $194.98 | $263.03 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $151.36 Typical High $169.82 | Facility | None | $66.07 | $151.36 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $281.84 | Professional | None | $204.17 | $251.19 | $281.84 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $295.12 Typical High $1,174.90 | Facility | None | $95.50 | $295.12 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $1,584.89 Typical High $1,659.59 | Professional | None | $190.55 | $1,584.89 | $1,659.59 |
United Setting Facility Modifier None Typical Low $89.13 Median $602.56 Typical High $1,380.38 | Facility | None | $89.13 | $602.56 | $1,380.38 |
United Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $302.00 | Professional | None | $169.82 | $208.93 | $302.00 |
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 $107.15 Median $107.15 Typical High $112.20 | Professional | 52 · Reduced service | $107.15 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $45.71 | Professional | 53 · Discontinued | $42.66 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $169.82 | Professional | 54 · Surgery only | $158.49 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $33.88 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $158.49 |
Where Oklahoma sits
The same service costs 5.1 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· 27th of 51
$263
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.