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 $74.13 Median $354.81 Typical High $457.09 | Professional | None | $74.13 | $354.81 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $263.03 Median $346.74 Typical High $489.78 | Facility | None | $263.03 | $346.74 | $489.78 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $79.43 Median $398.11 Typical High $549.54 | Professional | None | $79.43 | $398.11 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $169.82 Typical High $478.63 | Professional | None | $83.18 | $169.82 | $478.63 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $3,890.45 Typical High $8,128.31 | Facility | None | $83.18 | $3,890.45 | $8,128.31 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $1,548.82 Typical High $3,090.30 | Professional | None | $389.05 | $1,548.82 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,888.44 Typical High $9,120.11 | Facility | None | $1,584.89 | $5,888.44 | $9,120.11 |
United Setting Professional Modifier None Typical Low $66.07 Median $275.42 Typical High $562.34 | Professional | None | $66.07 | $275.42 | $562.34 |
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 $37.15 Median $58.88 Typical High $229.09 | Professional | 52 · Reduced service | $37.15 | $58.88 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $23.44 Typical High $91.20 | Professional | 53 · Discontinued | $15.14 | $23.44 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $89.13 Typical High $338.84 | Professional | 54 · Surgery only | $56.23 | $89.13 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $17.78 Typical High $69.18 | Professional | 55 · Aftercare only | $11.22 | $17.78 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $11.75 Typical High $45.71 | Professional | 56 · Pre-op care only | $7.41 | $11.75 | $45.71 |
Where Oklahoma sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 8th of 51
$447
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.