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 $173.78 Median $234.42 Typical High $275.42 | Professional | None | $173.78 | $234.42 | $275.42 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,023.29 Median $4,897.79 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,897.79 | $8,511.38 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $338.84 | Professional | None | $158.49 | $218.78 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $229.09 Typical High $630.96 | Facility | None | $190.55 | $229.09 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $302.00 | Professional | None | $181.97 | $257.04 | $302.00 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $380.19 Typical High $3,981.07 | Facility | None | $223.87 | $380.19 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $1,202.26 Typical High $1,862.09 | Professional | None | $239.88 | $1,202.26 | $1,862.09 |
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 $147.91 Median $223.87 Typical High $323.59 | Professional | None | $147.91 | $223.87 | $323.59 |
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 $87.10 Median $117.49 Typical High $138.04 | Professional | 52 · Reduced service | $87.10 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $34.67 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $173.78 Typical High $204.17 | Professional | 54 · Surgery only | $131.83 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $34.67 Typical High $40.74 | Professional | 55 · Aftercare only | $26.30 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.38 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $162.18 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $123.03 | $162.18 | $190.55 |
Where Oklahoma sits
The same service costs 3.6 times more in Alaska 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· 23rd of 51
$282
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.