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 $831.76 Median $3,090.30 Typical High $8,317.64 | Facility | None | $831.76 | $3,090.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $3,162.28 | Professional | None | $208.93 | $309.03 | $3,162.28 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $616.60 Median $1,023.29 Typical High $1,621.81 | Facility | None | $616.60 | $1,023.29 | $1,621.81 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $389.05 | Professional | None | $239.88 | $346.74 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $371.54 Typical High $630.96 | Facility | None | $302.00 | $371.54 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $407.38 | Professional | None | $223.87 | $323.59 | $407.38 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $436.52 Typical High $1,659.59 | Facility | None | $114.82 | $436.52 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $1,698.24 Typical High $2,187.76 | Professional | None | $288.40 | $1,698.24 | $2,187.76 |
United Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $1,380.38 | Facility | None | $89.13 | $616.60 | $1,380.38 |
United Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $457.09 | Professional | None | $194.98 | $295.12 | $457.09 |
6 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 $104.71 Typical High $151.36 | Professional | 52 · Reduced service | $104.71 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $61.66 | Professional | 53 · Discontinued | $41.69 | $41.69 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $229.09 | Professional | 54 · Surgery only | $154.88 | $154.88 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $45.71 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $213.80 |
Where Oklahoma sits
The same service costs 3.7 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· 17th of 51
$389
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.