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 $302.00 Median $398.11 Typical High $3,162.28 | Professional | None | $302.00 | $398.11 | $3,162.28 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,380.38 Median $6,025.60 Typical High $10,471.29 | Facility | None | $1,380.38 | $6,025.60 | $10,471.29 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $524.81 | Professional | None | $338.84 | $446.68 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,621.81 Typical High $1,995.26 | Facility | None | $512.86 | $1,621.81 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $512.86 | Professional | None | $309.03 | $416.87 | $512.86 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $562.34 Typical High $6,025.60 | Facility | None | $416.87 | $562.34 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $2,137.96 Typical High $2,754.23 | Professional | None | $363.08 | $2,137.96 | $2,754.23 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $6,309.57 | Facility | None | $933.25 | $2,951.21 | $6,309.57 |
United Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $575.44 | Professional | None | $275.42 | $380.19 | $575.44 |
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 $151.36 Median $151.36 Typical High $199.53 | Professional | 52 · Reduced service | $151.36 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $79.43 | Professional | 53 · Discontinued | $60.26 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $295.12 | Professional | 54 · Surgery only | $223.87 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $58.88 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $275.42 |
Where Oklahoma sits
The same service costs 4.9 times more in Alaska 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· 4th of 51
$871
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.