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 $281.84 Median $2,454.71 Typical High $7,585.78 | Facility | None | $281.84 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $194.98 Typical High $213.80 | Professional | None | $87.10 | $194.98 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $190.55 Median $257.04 Typical High $354.81 | Facility | None | $190.55 | $257.04 | $354.81 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $75.86 Median $169.82 Typical High $234.42 | Professional | None | $75.86 | $169.82 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $234.42 | Professional | None | $85.11 | $125.89 | $234.42 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $602.56 Typical High $2,570.40 | Facility | None | $89.13 | $602.56 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $660.69 Typical High $1,258.93 | Professional | None | $190.55 | $660.69 | $1,258.93 |
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 $69.18 Median $144.54 Typical High $288.40 | Professional | None | $69.18 | $144.54 | $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 $43.65 Median $58.88 Typical High $107.15 | Professional | 52 · Reduced service | $43.65 | $58.88 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $23.44 Typical High $42.66 | Professional | 53 · Discontinued | $17.38 | $23.44 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $89.13 Typical High $158.49 | Professional | 54 · Surgery only | $66.07 | $89.13 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $17.78 Typical High $31.62 | Professional | 55 · Aftercare only | $13.18 | $17.78 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.75 Typical High $21.38 | Professional | 56 · Pre-op care only | $8.71 | $11.75 | $21.38 |
Where Oklahoma sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 14th of 51
$200
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.