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 $831.76 Median $3,090.30 Typical High $8,317.64 | Facility | None | $831.76 | $3,090.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $295.12 Typical High $562.34 | Professional | None | $147.91 | $295.12 | $562.34 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,584.89 Median $2,630.27 Typical High $4,073.80 | Facility | None | $1,584.89 | $2,630.27 | $4,073.80 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $346.74 | Professional | None | $128.82 | $177.83 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $269.15 Typical High $630.96 | Facility | None | $218.78 | $269.15 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $354.81 | Professional | None | $154.88 | $234.42 | $354.81 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $371.54 Typical High $1,659.59 | Facility | None | $114.82 | $371.54 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $1,862.09 Typical High $2,041.74 | Professional | None | $257.04 | $1,862.09 | $2,041.74 |
United Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $1,380.38 | Facility | None | $89.13 | $616.60 | $1,380.38 |
United Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $389.05 | Professional | None | $125.89 | $213.80 | $389.05 |
5 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 $74.13 Median $75.86 Typical High $151.36 | Professional | 52 · Reduced service | $74.13 | $75.86 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $30.20 Typical High $60.26 | Professional | 53 · Discontinued | $29.51 | $30.20 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $229.09 | Professional | 54 · Surgery only | $112.20 | $112.20 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $45.71 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.14 Typical High $30.20 | Professional | 56 · Pre-op care only | $14.79 | $15.14 | $30.20 |
Where Oklahoma sits
The same service costs 3.2 times more in Wisconsin than in Kentucky. 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· 5th of 51
$427
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.