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 $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 $218.78 Median $389.05 Typical High $3,162.28 | Professional | None | $218.78 | $389.05 | $3,162.28 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $3,801.89 Median $6,309.57 Typical High $9,772.37 | Facility | None | $3,801.89 | $6,309.57 | $9,772.37 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $389.05 Typical High $630.96 | Facility | None | $316.23 | $389.05 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $436.52 | Professional | None | $223.87 | $331.13 | $436.52 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $426.58 Typical High $4,073.80 | Facility | None | $275.42 | $426.58 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $1,584.89 Typical High $2,630.27 | Professional | None | $302.00 | $1,584.89 | $2,630.27 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,819.70 Typical High $3,630.78 | Facility | None | $467.74 | $1,819.70 | $3,630.78 |
United Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $489.78 | Professional | None | $181.97 | $288.40 | $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 $109.65 Median $109.65 Typical High $199.53 | Professional | 52 · Reduced service | $109.65 | $109.65 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $44.67 Typical High $79.43 | Professional | 53 · Discontinued | $43.65 | $44.67 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $165.96 Typical High $302.00 | Professional | 54 · Surgery only | $162.18 | $165.96 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.11 Typical High $60.26 | Professional | 55 · Aftercare only | $32.36 | $33.11 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $39.81 |
Where Oklahoma sits
The same service costs 3.0 times more in Wisconsin 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· 4th of 51
$603
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.