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 $630.96 Median $2,454.71 Typical High $7,585.78 | Facility | None | $630.96 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $524.81 Typical High $891.25 | Professional | None | $194.98 | $524.81 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $363.08 Median $3,548.13 Typical High $7,244.36 | Facility | None | $363.08 | $3,548.13 | $7,244.36 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $162.18 Median $676.08 Typical High $933.25 | Professional | None | $162.18 | $676.08 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $630.96 Typical High $891.25 | Facility | None | $549.54 | $630.96 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $812.83 | Professional | None | $199.53 | $269.15 | $812.83 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $1,000.00 Typical High $4,168.69 | Facility | None | $213.80 | $1,000.00 | $4,168.69 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $2,630.27 Typical High $5,128.61 | Professional | None | $575.44 | $2,630.27 | $5,128.61 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,041.74 Typical High $3,890.45 | Facility | None | $467.74 | $2,041.74 | $3,890.45 |
United Setting Professional Modifier None Typical Low $154.88 Median $501.19 Typical High $1,000.00 | Professional | None | $154.88 | $501.19 | $1,000.00 |
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 $104.71 Median $134.90 Typical High $446.68 | Professional | 52 · Reduced service | $104.71 | $134.90 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $53.70 Typical High $177.83 | Professional | 53 · Discontinued | $41.69 | $53.70 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $199.53 Typical High $676.08 | Professional | 54 · Surgery only | $154.88 | $199.53 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $40.74 Typical High $134.90 | Professional | 55 · Aftercare only | $31.62 | $40.74 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $26.92 Typical High $89.13 | Professional | 56 · Pre-op care only | $20.89 | $26.92 | $89.13 |
Where Oklahoma sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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
$759
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.