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 $331.13 Median $3,890.45 Typical High $18,620.87 | Facility | None | $331.13 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $323.59 Typical High $331.13 | Professional | None | $194.98 | $323.59 | $331.13 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $549.54 Median $912.01 Typical High $1,412.54 | Facility | None | $549.54 | $912.01 | $1,412.54 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $177.83 Median $302.00 Typical High $407.38 | Professional | None | $177.83 | $302.00 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $363.08 Typical High $724.44 | Facility | None | $302.00 | $363.08 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $363.08 | Professional | None | $194.98 | $223.87 | $363.08 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $331.13 Typical High $2,398.83 | Facility | None | $181.97 | $331.13 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $1,380.38 Typical High $2,290.87 | Professional | None | $186.21 | $1,380.38 | $2,290.87 |
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 $138.04 Median $213.80 Typical High $338.84 | Professional | None | $138.04 | $213.80 | $338.84 |
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 $95.50 Median $125.89 Typical High $165.96 | Professional | 52 · Reduced service | $95.50 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $50.12 Typical High $67.61 | Professional | 53 · Discontinued | $38.02 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $186.21 Typical High $251.19 | Professional | 54 · Surgery only | $144.54 | $186.21 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $37.15 Typical High $50.12 | Professional | 55 · Aftercare only | $28.84 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $25.12 Typical High $33.11 | Professional | 56 · Pre-op care only | $19.05 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $173.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $134.90 | $173.78 | $234.42 |
Where Oklahoma sits
The same service costs 4.5 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· 22nd of 51
$309
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.