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 $114.82 Median $114.82 Typical High $154.88 | Professional | None | $114.82 | $114.82 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,949.84 Median $3,235.94 Typical High $5,011.87 | Facility | None | $1,949.84 | $3,235.94 | $5,011.87 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $190.55 | Professional | None | $102.33 | $141.25 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $123.03 Typical High $467.74 | Facility | None | $102.33 | $123.03 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $181.97 | Professional | None | $117.49 | $147.91 | $181.97 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $213.80 Typical High $3,715.35 | Facility | None | $147.91 | $213.80 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $831.76 Typical High $1,096.48 | Professional | None | $138.04 | $831.76 | $1,096.48 |
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 $95.50 Median $128.82 Typical High $186.21 | Professional | None | $95.50 | $128.82 | $186.21 |
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 $57.54 Median $69.18 Typical High $77.62 | Professional | 52 · Reduced service | $57.54 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $27.54 Typical High $30.90 | Professional | 53 · Discontinued | $22.91 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $104.71 Typical High $117.49 | Professional | 54 · Surgery only | $87.10 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.89 Typical High $23.44 | Professional | 55 · Aftercare only | $17.38 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.80 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.48 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $97.72 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $81.28 | $97.72 | $109.65 |
Where Oklahoma sits
The same service costs 4.0 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· 31st of 51
$158
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.