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 $67.61 Median $100.00 Typical High $125.89 | Professional | None | $67.61 | $100.00 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $3,981.07 Median $6,456.54 Typical High $10,000.00 | Facility | None | $3,981.07 | $6,456.54 | $10,000.00 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $131.83 | Professional | None | $63.10 | $95.50 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $72.44 Typical High $467.74 | Facility | None | $60.26 | $72.44 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $134.90 | Professional | None | $77.62 | $107.15 | $134.90 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $125.89 Typical High $2,398.83 | Facility | None | $93.33 | $125.89 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $758.58 Typical High $776.25 | Professional | None | $89.13 | $758.58 | $776.25 |
United Setting Facility Modifier None Typical Low $269.15 Median $1,258.93 Typical High $2,454.71 | Facility | None | $269.15 | $1,258.93 | $2,454.71 |
United Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $134.90 | Professional | None | $61.66 | $87.10 | $134.90 |
5 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 $33.88 Median $33.88 Typical High $52.48 | Professional | 52 · Reduced service | $33.88 | $33.88 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $21.38 | Professional | 53 · Discontinued | $13.49 | $13.49 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $51.29 Typical High $79.43 | Professional | 54 · Surgery only | $50.12 | $51.29 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $15.85 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $10.47 |
Where Oklahoma sits
The same service costs 3.6 times more in Wisconsin 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· 9th of 51
$148
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.