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 $91.20 Median $275.42 Typical High $363.08 | Professional | None | $91.20 | $275.42 | $363.08 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $575.44 Median $776.25 Typical High $1,071.52 | Facility | None | $575.44 | $776.25 | $1,071.52 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $81.28 Median $331.13 Typical High $457.09 | Professional | None | $81.28 | $331.13 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $1,122.02 | Facility | None | $141.25 | $169.82 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $371.54 | Professional | None | $104.71 | $162.18 | $371.54 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $457.09 Typical High $1,862.09 | Facility | None | $85.11 | $457.09 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $1,174.90 Typical High $2,454.71 | Professional | None | $316.23 | $1,174.90 | $2,454.71 |
United Setting Facility Modifier None Typical Low $89.13 Median $602.56 Typical High $1,380.38 | Facility | None | $89.13 | $602.56 | $1,380.38 |
United Setting Professional Modifier None Typical Low $74.13 Median $208.93 Typical High $416.87 | Professional | None | $74.13 | $208.93 | $416.87 |
5 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 $45.71 Median $123.03 Typical High $181.97 | Professional | 52 · Reduced service | $45.71 | $123.03 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $50.12 Typical High $74.13 | Professional | 53 · Discontinued | $18.20 | $50.12 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $186.21 Typical High $275.42 | Professional | 54 · Surgery only | $67.61 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $37.15 Typical High $54.95 | Professional | 55 · Aftercare only | $13.49 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $24.55 Typical High $36.31 | Professional | 56 · Pre-op care only | $9.12 | $24.55 | $36.31 |
Where Oklahoma sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 12th of 51
$355
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.