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 $208.93 Median $234.42 Typical High $3,162.28 | Professional | None | $208.93 | $234.42 | $3,162.28 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,348.96 Median $5,370.32 Typical High $9,332.54 | Facility | None | $1,348.96 | $5,370.32 | $9,332.54 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $338.84 | Professional | None | $173.78 | $223.87 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,905.46 Typical High $2,187.76 | Facility | None | $512.86 | $1,905.46 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $309.03 | Professional | None | $199.53 | $257.04 | $309.03 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $363.08 Typical High $6,025.60 | Facility | None | $251.19 | $363.08 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $1,380.38 Typical High $2,238.72 | Professional | None | $208.93 | $1,380.38 | $2,238.72 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $6,309.57 | Facility | None | $933.25 | $2,951.21 | $6,309.57 |
United Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $331.13 | Professional | None | $165.96 | $218.78 | $331.13 |
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 $102.33 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $102.33 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $47.86 | Professional | 53 · Discontinued | $41.69 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $158.49 Typical High $181.97 | Professional | 54 · Surgery only | $154.88 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $30.90 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $23.99 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $147.91 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $144.54 | $147.91 | $169.82 |
Where Oklahoma sits
The same service costs 5.9 times more in Oklahoma 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· 1st of 51
$1,175
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.