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 $102.33 Median $151.36 Typical High $186.21 | Professional | None | $102.33 | $151.36 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $165.96 | Professional | None | $117.49 | $165.96 | $165.96 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $933.25 Median $1,548.82 Typical High $2,398.83 | Facility | None | $933.25 | $1,548.82 | $2,398.83 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $194.98 | Professional | None | $100.00 | $144.54 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $97.72 Typical High $467.74 | Facility | None | $83.18 | $97.72 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $194.98 | Professional | None | $114.82 | $158.49 | $194.98 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $190.55 Typical High $1,174.90 | Facility | None | $93.33 | $190.55 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $741.31 Typical High $1,122.02 | Professional | None | $134.90 | $741.31 | $1,122.02 |
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 $95.50 Median $134.90 Typical High $208.93 | Professional | None | $95.50 | $134.90 | $208.93 |
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 $51.29 Median $52.48 Typical High $77.62 | Professional | 52 · Reduced service | $51.29 | $52.48 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $30.90 | Professional | 53 · Discontinued | $20.89 | $20.89 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $117.49 | Professional | 54 · Surgery only | $77.62 | $77.62 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $23.44 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.47 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.23 | $10.47 | $15.49 |
Where Oklahoma sits
The same service costs 3.2 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· 16th of 51
$191
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.