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 $173.78 Median $3,890.45 Typical High $18,620.87 | Facility | None | $173.78 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $173.78 | Professional | None | $104.71 | $141.25 | $173.78 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $173.78 Median $323.59 Typical High $1,000.00 | Facility | None | $173.78 | $323.59 | $1,000.00 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $181.97 | Professional | None | $100.00 | $134.90 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $125.89 | Facility | None | $50.12 | $75.86 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $190.55 | Professional | None | $117.49 | $151.36 | $190.55 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $181.97 Typical High $1,174.90 | Facility | None | $95.50 | $181.97 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $794.33 Typical High $1,071.52 | Professional | None | $125.89 | $794.33 | $1,071.52 |
United Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $1,380.38 | Facility | None | $89.13 | $616.60 | $1,380.38 |
United Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $204.17 | Professional | None | $93.33 | $125.89 | $204.17 |
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 $52.48 Median $64.57 Typical High $87.10 | Professional | 52 · Reduced service | $52.48 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $25.70 Typical High $34.67 | Professional | 53 · Discontinued | $20.89 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $97.72 Typical High $131.83 | Professional | 54 · Surgery only | $79.43 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.50 Typical High $26.30 | Professional | 55 · Aftercare only | $15.85 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.88 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.47 | $12.88 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $91.20 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $74.13 | $91.20 | $123.03 |
Where Oklahoma sits
The same service costs 4.2 times more in Alaska 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· 28th of 51
$166
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.