How much rates vary
Facilitymedian $5,495 · 10th to 90th $372 to $12,589Professionalmedian $372 · 10th to 90th $224 to $2,630
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 $831.76 Median $3,090.30 Typical High $8,317.64 | Facility | None | $831.76 | $3,090.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $398.11 Typical High $3,162.28 | Professional | None | $223.87 | $398.11 | $3,162.28 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $5,623.41 Median $9,332.54 Typical High $14,454.40 | Facility | None | $5,623.41 | $9,332.54 | $14,454.40 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,096.48 Typical High $1,348.96 | Facility | None | $512.86 | $1,096.48 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $446.68 | Professional | None | $229.09 | $331.13 | $446.68 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $562.34 Typical High $5,888.44 | Facility | None | $281.84 | $562.34 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $1,479.11 Typical High $2,630.27 | Professional | None | $302.00 | $1,479.11 | $2,630.27 |
United Setting Facility Modifier None Typical Low $912.01 Median $2,951.21 Typical High $6,025.60 | Facility | None | $912.01 | $2,951.21 | $6,025.60 |
United Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $489.78 | Professional | None | $190.55 | $295.12 | $489.78 |
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 $112.20 Median $114.82 Typical High $199.53 | Professional | 52 · Reduced service | $112.20 | $114.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $45.71 Typical High $81.28 | Professional | 53 · Discontinued | $44.67 | $45.71 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $302.00 | Professional | 54 · Surgery only | $169.82 | $169.82 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $60.26 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.91 Typical High $40.74 | Professional | 56 · Pre-op care only | $22.39 | $22.91 | $40.74 |
Where Oklahoma sits
The same service costs 7.9 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $5,867MT $745
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.