How much rates vary
Facilitymedian $2,399 · 10th to 90th $389 to $5,623Professionalmedian $398 · 10th to 90th $219 to $759
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 $323.59 Median $1,445.44 Typical High $6,760.83 | Facility | None | $323.59 | $1,445.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $389.05 Typical High $389.05 | Professional | None | $169.82 | $389.05 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | None | $389.05 | $389.05 | $524.81 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $602.56 Median $2,818.38 Typical High $4,677.35 | Facility | None | $602.56 | $2,818.38 | $4,677.35 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $549.54 | Professional | None | $229.09 | $398.11 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,047.13 Typical High $1,258.93 | Facility | None | $575.44 | $1,047.13 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $512.86 | Professional | None | $239.88 | $346.74 | $512.86 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $870.96 Typical High $6,025.60 | Facility | None | $309.03 | $870.96 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $758.58 Typical High $3,235.94 | Professional | None | $389.05 | $758.58 | $3,235.94 |
United Setting Facility Modifier None Typical Low $912.01 Median $2,951.21 Typical High $6,025.60 | Facility | None | $912.01 | $2,951.21 | $6,025.60 |
United Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $602.56 | Professional | None | $199.53 | $346.74 | $602.56 |
7 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 $85.11 Median $104.71 Typical High $194.98 | Professional | 52 · Reduced service | $85.11 | $104.71 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $42.66 Typical High $77.62 | Professional | 53 · Discontinued | $33.88 | $42.66 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $158.49 Typical High $295.12 | Professional | 54 · Surgery only | $128.82 | $158.49 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $58.88 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.38 Typical High $38.90 | Professional | 56 · Pre-op care only | $16.98 | $21.38 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $147.91 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $120.23 | $147.91 | $275.42 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $630.96 Typical High $794.33 | Professional | 50 · Both sides | $245.47 | $630.96 | $794.33 |
Where Oklahoma sits
The same service costs 4.6 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,728MT $1,029
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.