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 $151.36 Median $213.80 Typical High $245.47 | Professional | None | $151.36 | $213.80 | $245.47 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $3,467.37 Median $5,754.40 Typical High $8,912.51 | Facility | None | $3,467.37 | $5,754.40 | $8,912.51 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $302.00 | Professional | None | $134.90 | $186.21 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $204.17 Typical High $467.74 | Facility | None | $169.82 | $204.17 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $263.03 | Professional | None | $158.49 | $223.87 | $263.03 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $331.13 Typical High $3,890.45 | Facility | None | $208.93 | $331.13 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $1,047.13 Typical High $1,698.24 | Professional | None | $218.78 | $1,047.13 | $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 $125.89 Median $199.53 Typical High $281.84 | Professional | None | $125.89 | $199.53 | $281.84 |
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 $75.86 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $75.86 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $30.20 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $114.82 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $22.91 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.14 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $144.54 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $107.15 | $144.54 | $173.78 |
Where Oklahoma sits
The same service costs 3.5 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· 25th of 51
$245
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.