How much rates vary
Facilitymedian $912 · 10th to 90th $195 to $3,311Professionalmedian $219 · 10th to 90th $141 to $1,660
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 $131.83 Median $199.53 Typical High $281.84 | Professional | None | $131.83 | $199.53 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $234.42 Median $870.96 Typical High $1,445.44 | Facility | None | $234.42 | $870.96 | $1,445.44 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $295.12 | Professional | None | $154.88 | $199.53 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,258.93 Typical High $1,513.56 | Facility | None | $407.38 | $1,258.93 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $263.03 | Professional | None | $144.54 | $208.93 | $263.03 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $302.00 Typical High $4,073.80 | Facility | None | $177.83 | $302.00 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $1,122.02 Typical High $1,659.59 | Professional | None | $190.55 | $1,122.02 | $1,659.59 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,041.74 Typical High $4,265.80 | Facility | None | $467.74 | $2,041.74 | $4,265.80 |
United Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $288.40 | Professional | None | $120.23 | $186.21 | $288.40 |
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 $66.07 Median $81.28 Typical High $123.03 | Professional | 52 · Reduced service | $66.07 | $81.28 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $33.11 Typical High $48.98 | Professional | 53 · Discontinued | $26.92 | $33.11 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $123.03 Typical High $181.97 | Professional | 54 · Surgery only | $100.00 | $123.03 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $24.55 Typical High $36.31 | Professional | 55 · Aftercare only | $19.95 | $24.55 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.60 Typical High $24.55 | Professional | 56 · Pre-op care only | $13.18 | $16.60 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $114.82 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $93.33 | $114.82 | $169.82 |
Where Oklahoma sits
The same service costs 9.9 times more in Colorado 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
CO $4,605MT $466
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.