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 $741.31 Median $2,818.38 Typical High $8,317.64 | Facility | None | $741.31 | $2,818.38 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $602.56 Typical High $758.58 | Professional | None | $173.78 | $602.56 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $3,890.45 Median $5,128.61 Typical High $7,244.36 | Facility | None | $3,890.45 | $5,128.61 | $7,244.36 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $151.36 Median $575.44 Typical High $794.33 | Professional | None | $151.36 | $575.44 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $831.76 | Professional | None | $190.55 | $263.03 | $831.76 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $812.83 Typical High $1,548.82 | Facility | None | $181.97 | $812.83 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $2,187.76 Typical High $4,265.80 | Professional | None | $602.56 | $2,187.76 | $4,265.80 |
United Setting Facility Modifier None Typical Low $165.96 Median $891.25 Typical High $1,548.82 | Facility | None | $165.96 | $891.25 | $1,548.82 |
United Setting Professional Modifier None Typical Low $131.83 Median $426.58 Typical High $912.01 | Professional | None | $131.83 | $426.58 | $912.01 |
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 $85.11 Median $112.20 Typical High $380.19 | Professional | 52 · Reduced service | $85.11 | $112.20 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $44.67 Typical High $151.36 | Professional | 53 · Discontinued | $34.67 | $44.67 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $165.96 Typical High $575.44 | Professional | 54 · Surgery only | $128.82 | $165.96 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.88 Typical High $114.82 | Professional | 55 · Aftercare only | $25.70 | $33.88 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.39 Typical High $75.86 | Professional | 56 · Pre-op care only | $17.38 | $22.39 | $75.86 |
Where Oklahoma sits
The same service costs 3.8 times more in Wisconsin than in Nebraska. 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
$724
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.