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 $218.78 Median $331.13 Typical High $2,570.40 | Professional | None | $218.78 | $331.13 | $2,570.40 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $3,467.37 Median $5,754.40 Typical High $8,912.51 | Facility | None | $3,467.37 | $5,754.40 | $8,912.51 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $457.09 | Professional | None | $269.15 | $407.38 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $363.08 Typical High $467.74 | Facility | None | $302.00 | $363.08 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $416.87 | Professional | None | $229.09 | $316.23 | $416.87 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $467.74 Typical High $1,659.59 | Facility | None | $114.82 | $467.74 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $1,513.56 Typical High $2,187.76 | Professional | None | $316.23 | $1,513.56 | $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 $208.93 Median $309.03 Typical High $549.54 | Professional | None | $208.93 | $309.03 | $549.54 |
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 $109.65 Median $109.65 Typical High $165.96 | Professional | 52 · Reduced service | $109.65 | $109.65 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $66.07 | Professional | 53 · Discontinued | $43.65 | $43.65 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $245.47 | Professional | 54 · Surgery only | $165.96 | $165.96 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $48.98 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $33.11 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $229.09 |
Where Oklahoma sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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· 11th of 51
$457
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.