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 $1,000.00 Median $2,951.21 Typical High $8,317.64 | Facility | None | $1,000.00 | $2,951.21 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $1,479.11 Typical High $1,905.46 | Professional | None | $380.19 | $1,479.11 | $1,905.46 |
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 $331.13 Median $1,479.11 Typical High $2,041.74 | Professional | None | $331.13 | $1,479.11 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $2,344.23 | Professional | None | $426.58 | $549.54 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $2,187.76 Typical High $7,244.36 | Facility | None | $467.74 | $2,187.76 | $7,244.36 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $6,025.60 Typical High $11,481.54 | Professional | None | $1,548.82 | $6,025.60 | $11,481.54 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $5,888.44 Typical High $9,120.11 | Facility | None | $1,380.38 | $5,888.44 | $9,120.11 |
United Setting Professional Modifier None Typical Low $295.12 Median $1,174.90 Typical High $2,344.23 | Professional | None | $295.12 | $1,174.90 | $2,344.23 |
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 $194.98 Median $257.04 Typical High $954.99 | Professional | 52 · Reduced service | $194.98 | $257.04 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $102.33 Typical High $380.19 | Professional | 53 · Discontinued | $79.43 | $102.33 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $380.19 Typical High $1,445.44 | Professional | 54 · Surgery only | $295.12 | $380.19 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $75.86 Typical High $288.40 | Professional | 55 · Aftercare only | $58.88 | $75.86 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $51.29 Typical High $190.55 | Professional | 56 · Pre-op care only | $38.90 | $51.29 | $190.55 |
Where Oklahoma sits
The same service costs 5.6 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· 10th of 51
$1,778
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.