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 $162.18 Median $1,778.28 Typical High $6,760.83 | Facility | None | $162.18 | $1,778.28 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $3,162.28 | Professional | None | $114.82 | $169.82 | $3,162.28 |
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 $109.65 Median $154.88 Typical High $213.80 | Professional | None | $109.65 | $154.88 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $112.20 Typical High $724.44 | Facility | None | $93.33 | $112.20 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $204.17 | Professional | None | $125.89 | $169.82 | $204.17 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $194.98 Typical High $5,495.41 | Facility | None | $158.49 | $194.98 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $831.76 Typical High $1,258.93 | Professional | None | $138.04 | $831.76 | $1,258.93 |
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 $107.15 Median $141.25 Typical High $213.80 | Professional | None | $107.15 | $141.25 | $213.80 |
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 $57.54 Median $57.54 Typical High $87.10 | Professional | 52 · Reduced service | $57.54 | $57.54 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $34.67 | Professional | 53 · Discontinued | $22.91 | $22.91 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $87.10 Typical High $128.82 | Professional | 54 · Surgery only | $85.11 | $87.10 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $25.70 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $81.28 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $79.43 | $81.28 | $120.23 |
Where Oklahoma sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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· 8th of 51
$251
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.