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 $354.81 Median $436.52 Typical High $489.78 | Professional | None | $354.81 | $436.52 | $489.78 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $4,265.80 Median $7,079.46 Typical High $10,964.78 | Facility | None | $4,265.80 | $7,079.46 | $10,964.78 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $616.60 | Professional | None | $323.59 | $436.52 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,311.31 Typical High $3,801.89 | Facility | None | $512.86 | $3,311.31 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $524.81 | Professional | None | $363.08 | $457.09 | $524.81 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $660.69 Typical High $6,025.60 | Facility | None | $489.78 | $660.69 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $2,454.71 Typical High $3,311.31 | Professional | None | $416.87 | $2,454.71 | $3,311.31 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $6,309.57 | Facility | None | $933.25 | $2,951.21 | $6,309.57 |
United Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $575.44 | Professional | None | $295.12 | $407.38 | $575.44 |
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 $177.83 Median $213.80 Typical High $245.47 | Professional | 52 · Reduced service | $177.83 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $85.11 Typical High $97.72 | Professional | 53 · Discontinued | $70.79 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $323.59 Typical High $363.08 | Professional | 54 · Surgery only | $263.03 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $64.57 Typical High $72.44 | Professional | 55 · Aftercare only | $52.48 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $42.66 Typical High $48.98 | Professional | 56 · Pre-op care only | $35.48 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $302.00 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $245.47 | $302.00 | $338.84 |
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· 28th of 51
$501
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.