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 $1,621.81 Median $1,862.09 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,862.09 | $1,905.46 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $3,162.28 | Professional | None | $1,659.59 | $2,290.87 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $1,258.93 | Facility | None | $549.54 | $891.25 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,698.24 | $2,041.74 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $2,398.83 Typical High $5,888.44 | Facility | None | $398.11 | $2,398.83 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $12,302.69 | Professional | None | $1,548.82 | $1,995.26 | $12,302.69 |
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 $1,445.44 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,819.70 | $2,691.53 |
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 $812.83 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $812.83 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $323.59 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,230.27 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $245.47 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $162.18 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,288.25 | $1,288.25 |
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· 29th of 51
$2,042
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.