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 $128.82 Median $213.80 Typical High $275.42 | Professional | None | $128.82 | $213.80 | $275.42 |
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 $141.25 Median $204.17 Typical High $257.04 | Professional | None | $141.25 | $204.17 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $154.88 Typical High $467.74 | Facility | None | $128.82 | $154.88 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $295.12 | Professional | None | $134.90 | $218.78 | $295.12 |
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 $199.53 Median $1,621.81 Typical High $1,778.28 | Professional | None | $199.53 | $1,621.81 | $1,778.28 |
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 $123.03 Median $177.83 Typical High $288.40 | Professional | None | $123.03 | $177.83 | $288.40 |
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 $64.57 Median $66.07 Typical High $109.65 | Professional | 52 · Reduced service | $64.57 | $66.07 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $43.65 | Professional | 53 · Discontinued | $26.30 | $26.30 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $100.00 Typical High $165.96 | Professional | 54 · Surgery only | $97.72 | $100.00 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.95 Typical High $33.11 | Professional | 55 · Aftercare only | $19.50 | $19.95 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.18 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.88 | $13.18 | $21.88 |
Where Oklahoma sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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· 21st of 51
$251
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.