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 $288.40 Median $3,801.89 Typical High $13,182.57 | Facility | None | $288.40 | $3,801.89 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $239.88 | Professional | None | $223.87 | $223.87 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $213.80 | Professional | None | $109.65 | $123.03 | $213.80 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,258.93 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,258.93 | $6,025.60 | $10,232.93 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $269.15 | Professional | None | $199.53 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,621.81 Typical High $1,995.26 | Facility | None | $776.25 | $1,621.81 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $288.40 | Professional | None | $218.78 | $245.47 | $288.40 |
Medica Setting Facility Modifier None Typical Low $288.40 Median $1,202.26 Typical High $6,760.83 | Facility | None | $288.40 | $1,202.26 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $1,584.89 | Professional | None | $190.55 | $257.04 | $1,584.89 |
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 $169.82 Median $213.80 Typical High $316.23 | Professional | None | $169.82 | $213.80 | $316.23 |
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 $102.33 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $102.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $41.69 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $30.90 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $20.89 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $144.54 | $158.49 | $158.49 |
Where Oklahoma sits
The same service costs 5.6 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
$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.