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 $2,511.89 Typical High $7,585.78 | Facility | None | $630.96 | $2,511.89 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $229.09 Typical High $229.09 | Professional | None | $128.82 | $229.09 | $229.09 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,412.54 Median $5,011.87 Typical High $8,511.38 | Facility | None | $1,412.54 | $5,011.87 | $8,511.38 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $281.84 | Professional | None | $144.54 | $204.17 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $204.17 Typical High $724.44 | Facility | None | $169.82 | $204.17 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $275.42 | Professional | None | $138.04 | $208.93 | $275.42 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $3,890.45 | Facility | None | $177.83 | $288.40 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $912.01 Typical High $1,621.81 | Professional | None | $190.55 | $912.01 | $1,621.81 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,041.74 Typical High $4,265.80 | Facility | None | $467.74 | $2,041.74 | $4,265.80 |
United Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $331.13 | Professional | None | $114.82 | $190.55 | $331.13 |
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 $64.57 Median $64.57 Typical High $114.82 | Professional | 52 · Reduced service | $64.57 | $64.57 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $45.71 | Professional | 53 · Discontinued | $25.70 | $25.70 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $169.82 | Professional | 54 · Surgery only | $97.72 | $97.72 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $33.88 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $91.20 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $91.20 | $91.20 | $158.49 |
Where Oklahoma sits
The same service costs 3.8 times more in Wisconsin than in Kentucky. 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· 7th of 51
$347
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.