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 $912.01 Median $3,090.30 Typical High $8,317.64 | Facility | None | $912.01 | $3,090.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $741.31 Typical High $912.01 | Professional | None | $229.09 | $741.31 | $912.01 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $457.09 Median $602.56 Typical High $851.14 | Facility | None | $457.09 | $602.56 | $851.14 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $208.93 Median $645.65 Typical High $1,122.02 | Professional | None | $208.93 | $645.65 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $1,071.52 | Professional | None | $251.19 | $371.54 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $3,890.45 Typical High $8,128.31 | Facility | None | $245.47 | $3,890.45 | $8,128.31 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $3,090.30 Typical High $6,165.95 | Professional | None | $851.14 | $3,090.30 | $6,165.95 |
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 $199.53 Median $630.96 Typical High $1,230.27 | Professional | None | $199.53 | $630.96 | $1,230.27 |
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 $114.82 Median $173.78 Typical High $457.09 | Professional | 52 · Reduced service | $114.82 | $173.78 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $69.18 Typical High $181.97 | Professional | 53 · Discontinued | $45.71 | $69.18 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $263.03 Typical High $676.08 | Professional | 54 · Surgery only | $169.82 | $263.03 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $52.48 Typical High $134.90 | Professional | 55 · Aftercare only | $33.88 | $52.48 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $34.67 Typical High $91.20 | Professional | 56 · Pre-op care only | $22.91 | $34.67 | $91.20 |
Where Oklahoma sits
The same service costs 5.4 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· 12th of 51
$912
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.