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 $309.03 Median $2,454.71 Typical High $7,585.78 | Facility | None | $309.03 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $239.88 | Professional | None | $138.04 | $177.83 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $218.78 | Professional | None | $114.82 | $114.82 | $218.78 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,258.93 Median $4,897.79 Typical High $8,511.38 | Facility | None | $1,258.93 | $4,897.79 | $8,511.38 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $295.12 | Professional | None | $123.03 | $208.93 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $213.80 Typical High $467.74 | Facility | None | $173.78 | $213.80 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $251.19 | Professional | None | $141.25 | $204.17 | $251.19 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $302.00 Typical High $3,890.45 | Facility | None | $186.21 | $302.00 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $977.24 Typical High $1,698.24 | Professional | None | $194.98 | $977.24 | $1,698.24 |
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 $181.97 Typical High $257.04 | Professional | None | $114.82 | $181.97 | $257.04 |
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 $69.18 Median $97.72 Typical High $120.23 | Professional | 52 · Reduced service | $69.18 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.90 Typical High $48.98 | Professional | 53 · Discontinued | $27.54 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $144.54 Typical High $181.97 | Professional | 54 · Surgery only | $102.33 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $29.51 Typical High $36.31 | Professional | 55 · Aftercare only | $20.42 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.50 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.80 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $134.90 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $95.50 | $134.90 | $169.82 |
Where Oklahoma sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 19th of 51
$240
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.