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 $162.18 Median $204.17 Typical High $229.09 | Professional | None | $162.18 | $204.17 | $229.09 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $281.84 | Professional | None | $147.91 | $199.53 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $724.44 Typical High $891.25 | Facility | None | $407.38 | $724.44 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $251.19 | Professional | None | $165.96 | $208.93 | $251.19 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $302.00 Typical High $3,981.07 | Facility | None | $218.78 | $302.00 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $1,174.90 Typical High $1,621.81 | Professional | None | $194.98 | $1,174.90 | $1,621.81 |
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 $134.90 Median $186.21 Typical High $263.03 | Professional | None | $134.90 | $186.21 | $263.03 |
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 $81.28 Median $100.00 Typical High $114.82 | Professional | 52 · Reduced service | $81.28 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $39.81 Typical High $45.71 | Professional | 53 · Discontinued | $33.11 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $147.91 Typical High $169.82 | Professional | 54 · Surgery only | $123.03 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $29.51 Typical High $33.88 | Professional | 55 · Aftercare only | $24.55 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.95 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.22 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $138.04 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $114.82 | $138.04 | $158.49 |
Where Oklahoma sits
The same service costs 4.2 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· 26th of 51
$234
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.