How much rates vary
Facilitymedian $11,482 · 10th to 90th $1,479 to $26,303Professionalmedian $1,288 · 10th to 90th $977 to $2,188
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 $1,288.25 Median $3,801.89 Typical High $14,125.38 | Facility | None | $1,288.25 | $3,801.89 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | None | $1,122.02 | $1,122.02 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $1,071.52 Typical High $1,148.15 | Professional | None | $123.03 | $1,071.52 | $1,148.15 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $5,248.07 Median $17,378.01 Typical High $30,199.52 | Facility | None | $5,248.07 | $17,378.01 | $30,199.52 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,380.38 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,801.89 Typical High $4,677.35 | Facility | None | $870.96 | $3,801.89 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,288.25 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $2,818.38 Typical High $15,848.93 | Facility | None | $1,380.38 | $2,818.38 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $7,943.28 | Professional | None | $954.99 | $1,348.96 | $7,943.28 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $7,762.47 Typical High $15,135.61 | Facility | None | $1,905.46 | $7,762.47 | $15,135.61 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,584.89 | Professional | None | $891.25 | $1,122.02 | $1,584.89 |
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 $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $794.33 |
Where Oklahoma sits
The same service costs 4.2 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 $14,362MT $3,396
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.