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 $389.05 Median $3,388.44 Typical High $12,589.25 | Facility | None | $389.05 | $3,388.44 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | None | $309.03 | $309.03 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $309.03 | Professional | None | $245.47 | $295.12 | $309.03 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,318.26 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,318.26 | $6,025.60 | $10,232.93 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $380.19 | Professional | None | $275.42 | $354.81 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,090.30 Typical High $3,801.89 | Facility | None | $630.96 | $3,090.30 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $389.05 | Professional | None | $302.00 | $331.13 | $389.05 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $1,230.27 Typical High $6,165.95 | Facility | None | $407.38 | $1,230.27 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $2,630.27 | Professional | None | $269.15 | $363.08 | $2,630.27 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,235.94 Typical High $6,309.57 | Facility | None | $933.25 | $3,235.94 | $6,309.57 |
United Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $436.52 | Professional | None | $239.88 | $295.12 | $436.52 |
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 $141.25 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $141.25 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $61.66 Typical High $63.10 | Professional | 53 · Discontinued | $57.54 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $213.80 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $42.66 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.90 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.18 | $30.90 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $199.53 | $218.78 | $218.78 |
Where Oklahoma sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 33rd of 51
$347
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.