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 $512.86 Median $2,454.71 Typical High $7,585.78 | Facility | None | $512.86 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $512.86 | Professional | None | $223.87 | $239.88 | $512.86 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $575.44 Median $2,454.71 Typical High $4,073.80 | Facility | None | $575.44 | $2,454.71 | $4,073.80 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $354.81 | Professional | None | $213.80 | $288.40 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,737.80 Typical High $2,041.74 | Facility | None | $407.38 | $1,737.80 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $436.52 | Professional | None | $239.88 | $263.03 | $436.52 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $1,479.11 Typical High $8,709.64 | Facility | None | $537.03 | $1,479.11 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $2,290.87 | Professional | None | $208.93 | $389.05 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,073.80 Typical High $8,511.38 | Facility | None | $1,230.27 | $4,073.80 | $8,511.38 |
United Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $436.52 | Professional | None | $186.21 | $245.47 | $436.52 |
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 $112.20 Median $120.23 Typical High $144.54 | Professional | 52 · Reduced service | $112.20 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $47.86 Typical High $57.54 | Professional | 53 · Discontinued | $44.67 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $177.83 Typical High $213.80 | Professional | 54 · Surgery only | $169.82 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $35.48 Typical High $42.66 | Professional | 55 · Aftercare only | $33.88 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.99 Typical High $28.84 | Professional | 56 · Pre-op care only | $22.39 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $165.96 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $158.49 | $165.96 | $199.53 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 58 · Staged procedure | $257.04 | $257.04 | $257.04 |
Where Oklahoma sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 39th 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.