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 $1,288.25 Median $3,890.45 Typical High $18,620.87 | Facility | None | $1,288.25 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $1,995.26 | Professional | None | $1,737.80 | $1,949.84 | $1,995.26 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $3,311.31 | Professional | None | $1,737.80 | $2,398.83 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $4,786.30 | Facility | None | $549.54 | $891.25 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $2,454.71 | Professional | None | $1,819.70 | $2,187.76 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $2,511.89 Typical High $5,888.44 | Facility | None | $398.11 | $2,511.89 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $13,182.57 | Professional | None | $1,621.81 | $2,089.30 | $13,182.57 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,995.26 Typical High $6,025.60 | Facility | None | $426.58 | $1,995.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,818.38 | Professional | None | $1,513.56 | $1,905.46 | $2,818.38 |
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 $870.96 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $870.96 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $346.74 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,288.25 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $257.04 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $173.78 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,380.38 | $1,380.38 |
Where Oklahoma sits
The same service costs 5.4 times more in Alaska than in Texas. 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· 30th of 51
$2,138
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.