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 $1,000.00 Median $4,897.79 Typical High $14,125.38 | Facility | None | $1,000.00 | $4,897.79 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $354.81 | Professional | None | $295.12 | $338.84 | $354.81 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $3,467.37 Median $5,754.40 Typical High $8,912.51 | Facility | None | $3,467.37 | $5,754.40 | $8,912.51 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $660.69 | Professional | None | $354.81 | $446.68 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,905.46 Typical High $2,344.23 | Facility | None | $870.96 | $1,905.46 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $588.84 | Professional | None | $371.54 | $446.68 | $588.84 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $6,165.95 | Facility | None | $426.58 | $588.84 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $2,754.23 Typical High $3,162.28 | Professional | None | $380.19 | $2,754.23 | $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 $331.13 Median $426.58 Typical High $562.34 | Professional | None | $331.13 | $426.58 | $562.34 |
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 $147.91 Median $154.88 Typical High $177.83 | Professional | 52 · Reduced service | $147.91 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $61.66 Typical High $70.79 | Professional | 53 · Discontinued | $60.26 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $229.09 Typical High $263.03 | Professional | 54 · Surgery only | $223.87 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $46.77 Typical High $53.70 | Professional | 55 · Aftercare only | $44.67 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.90 Typical High $35.48 | Professional | 56 · Pre-op care only | $29.51 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $213.80 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $208.93 | $213.80 | $245.47 |
Where Oklahoma sits
The same service costs 4.3 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· 3rd of 51
$1,000
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.