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 $269.15 Median $1,445.44 Typical High $6,606.93 | Facility | None | $269.15 | $1,445.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $302.00 | Professional | None | $208.93 | $269.15 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $263.03 Typical High $389.05 | Professional | None | $95.50 | $263.03 | $389.05 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $691.83 Median $2,754.23 Typical High $4,786.30 | Facility | None | $691.83 | $2,754.23 | $4,786.30 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $371.54 | Professional | None | $186.21 | $275.42 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $295.12 Typical High $467.74 | Facility | None | $245.47 | $295.12 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $338.84 | Professional | None | $204.17 | $251.19 | $338.84 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $371.54 Typical High $2,398.83 | Facility | None | $263.03 | $371.54 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $1,445.44 Typical High $2,089.30 | Professional | None | $229.09 | $1,445.44 | $2,089.30 |
United Setting Facility Modifier None Typical Low $269.15 Median $1,258.93 Typical High $2,454.71 | Facility | None | $269.15 | $1,258.93 | $2,454.71 |
United Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $323.59 | Professional | None | $165.96 | $223.87 | $323.59 |
7 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 $131.83 Typical High $151.36 | Professional | 52 · Reduced service | $102.33 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $52.48 Typical High $60.26 | Professional | 53 · Discontinued | $40.74 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $199.53 Typical High $229.09 | Professional | 54 · Surgery only | $151.36 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $39.81 Typical High $45.71 | Professional | 55 · Aftercare only | $30.20 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $26.30 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.42 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $186.21 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $141.25 | $186.21 | $213.80 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 51 · Multiple procedures | $128.82 | $128.82 | $128.82 |
Where Oklahoma sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 25th of 51
$295
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.