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 $954.99 Median $3,801.89 Typical High $12,589.25 | Facility | None | $954.99 | $3,801.89 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $1,479.11 Typical High $2,454.71 | Professional | None | $436.52 | $1,479.11 | $2,454.71 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
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 $371.54 Median $1,905.46 Typical High $2,570.40 | Professional | None | $371.54 | $1,905.46 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $2,884.03 | Professional | None | $478.63 | $616.60 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $512.86 Median $2,454.71 Typical High $14,125.38 | Facility | None | $512.86 | $2,454.71 | $14,125.38 |
Medica Setting Professional Modifier None Typical Low $1,819.70 Median $7,585.78 Typical High $14,454.40 | Professional | None | $1,819.70 | $7,585.78 | $14,454.40 |
United Setting Facility Modifier None Typical Low $2,454.71 Median $10,000.00 Typical High $15,135.61 | Facility | None | $2,454.71 | $10,000.00 | $15,135.61 |
United Setting Professional Modifier None Typical Low $331.13 Median $1,412.54 Typical High $2,818.38 | Professional | None | $331.13 | $1,412.54 | $2,818.38 |
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 $218.78 Median $281.84 Typical High $1,230.27 | Professional | 52 · Reduced service | $218.78 | $281.84 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $114.82 Typical High $489.78 | Professional | 53 · Discontinued | $89.13 | $114.82 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $426.58 Typical High $1,819.70 | Professional | 54 · Surgery only | $331.13 | $426.58 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $85.11 Typical High $363.08 | Professional | 55 · Aftercare only | $66.07 | $85.11 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $57.54 Typical High $245.47 | Professional | 56 · Pre-op care only | $43.65 | $57.54 | $245.47 |
Where Oklahoma sits
The same service costs 6.2 times more in Washington 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· 8th of 51
$2,188
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.