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 $194.98 Median $3,890.45 Typical High $18,620.87 | Facility | None | $194.98 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $194.98 | Professional | None | $117.49 | $194.98 | $194.98 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $117.49 Median $154.88 Typical High $218.78 | Facility | None | $117.49 | $154.88 | $218.78 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $251.19 | Professional | None | $134.90 | $181.97 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $125.89 | Facility | None | $50.12 | $75.86 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $275.42 | Professional | None | $134.90 | $204.17 | $275.42 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $302.00 Typical High $4,073.80 | Facility | None | $162.18 | $302.00 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $851.14 Typical High $1,412.54 | Professional | None | $190.55 | $851.14 | $1,412.54 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,995.26 Typical High $3,630.78 | Facility | None | $467.74 | $1,995.26 | $3,630.78 |
United Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $302.00 | Professional | None | $112.20 | $181.97 | $302.00 |
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 $58.88 Median $58.88 Typical High $97.72 | Professional | 52 · Reduced service | $58.88 | $58.88 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $39.81 | Professional | 53 · Discontinued | $23.44 | $23.44 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $147.91 | Professional | 54 · Surgery only | $89.13 | $89.13 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $29.51 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $19.50 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $83.18 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $83.18 | $83.18 | $138.04 |
Where Oklahoma sits
The same service costs 3.8 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· 21st of 51
$224
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.