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 $186.21 Median $208.93 Typical High $2,570.40 | Professional | None | $186.21 | $208.93 | $2,570.40 |
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 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $288.40 | Professional | None | $147.91 | $190.55 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $109.65 Typical High $1,122.02 | Facility | None | $91.20 | $109.65 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $275.42 | Professional | None | $181.97 | $229.09 | $275.42 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $263.03 Typical High $5,495.41 | Facility | None | $213.80 | $263.03 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $1,230.27 Typical High $1,995.26 | Professional | None | $186.21 | $1,230.27 | $1,995.26 |
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 $151.36 Median $194.98 Typical High $295.12 | Professional | None | $151.36 | $194.98 | $295.12 |
6 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 $93.33 Median $93.33 Typical High $107.15 | Professional | 52 · Reduced service | $93.33 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.02 Typical High $42.66 | Professional | 53 · Discontinued | $37.15 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $141.25 Typical High $162.18 | Professional | 54 · Surgery only | $138.04 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.18 Typical High $32.36 | Professional | 55 · Aftercare only | $27.54 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.05 Typical High $21.38 | Professional | 56 · Pre-op care only | $18.62 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $131.83 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $128.82 | $131.83 | $151.36 |
Where Oklahoma sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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· 1st of 51
$891
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.