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 $234.42 Median $323.59 Typical High $371.54 | Professional | None | $234.42 | $323.59 | $371.54 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $3,715.35 Median $5,370.32 Typical High $7,762.47 | Facility | None | $3,715.35 | $5,370.32 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $316.23 Typical High $1,122.02 | Facility | None | $269.15 | $316.23 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $389.05 | Professional | None | $239.88 | $302.00 | $389.05 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $426.58 Typical High $3,467.37 | Facility | None | $302.00 | $426.58 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $1,737.80 Typical High $2,630.27 | Professional | None | $295.12 | $1,737.80 | $2,630.27 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,041.74 Typical High $3,890.45 | Facility | None | $467.74 | $2,041.74 | $3,890.45 |
United Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $416.87 | Professional | None | $199.53 | $288.40 | $416.87 |
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 $117.49 Median $154.88 Typical High $186.21 | Professional | 52 · Reduced service | $117.49 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $61.66 Typical High $74.13 | Professional | 53 · Discontinued | $46.77 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $229.09 Typical High $281.84 | Professional | 54 · Surgery only | $173.78 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $45.71 Typical High $56.23 | Professional | 55 · Aftercare only | $35.48 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $30.90 Typical High $37.15 | Professional | 56 · Pre-op care only | $23.44 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $213.80 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $162.18 | $213.80 | $263.03 |
Where Oklahoma sits
The same service costs 3.6 times more in Alaska than in New Jersey. 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· 23rd of 51
$372
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.