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 $190.55 Median $251.19 Typical High $2,570.40 | Professional | None | $190.55 | $251.19 | $2,570.40 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $3,981.07 Median $6,606.93 Typical High $10,232.93 | Facility | None | $3,981.07 | $6,606.93 | $10,232.93 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $316.23 | Professional | None | $177.83 | $245.47 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,862.09 Typical High $2,187.76 | Facility | None | $407.38 | $1,862.09 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $295.12 | Professional | None | $181.97 | $251.19 | $295.12 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $363.08 Typical High $6,025.60 | Facility | None | $239.88 | $363.08 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $338.84 Typical High $3,162.28 | Professional | None | $190.55 | $338.84 | $3,162.28 |
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 $158.49 Median $208.93 Typical High $331.13 | Professional | None | $158.49 | $208.93 | $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 $95.50 Median $95.50 Typical High $125.89 | Professional | 52 · Reduced service | $95.50 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | 53 · Discontinued | $38.02 | $38.02 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $144.54 Typical High $190.55 | Professional | 54 · Surgery only | $141.25 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.84 Typical High $38.02 | Professional | 55 · Aftercare only | $28.18 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $25.12 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $134.90 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $131.83 | $134.90 | $177.83 |
Where Oklahoma sits
The same service costs 4.4 times more in Alaska 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· 20th of 51
$316
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.