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 $104.71 Median $154.88 Typical High $158.49 | Professional | None | $104.71 | $154.88 | $158.49 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $2,951.21 | Facility | None | $1,148.15 | $1,905.46 | $2,951.21 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $229.09 | Professional | None | $141.25 | $165.96 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $141.25 Typical High $724.44 | Facility | None | $114.82 | $141.25 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $213.80 | Professional | None | $141.25 | $186.21 | $213.80 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $524.81 Typical High $2,691.53 | Facility | None | $109.65 | $524.81 | $2,691.53 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $1,318.26 | Professional | None | $151.36 | $281.84 | $1,318.26 |
United Setting Facility Modifier None Typical Low $269.15 Median $1,148.15 Typical High $2,454.71 | Facility | None | $269.15 | $1,148.15 | $2,454.71 |
United Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $218.78 | Professional | None | $102.33 | $151.36 | $218.78 |
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 $52.48 Median $53.70 Typical High $79.43 | Professional | 52 · Reduced service | $52.48 | $53.70 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.38 Typical High $31.62 | Professional | 53 · Discontinued | $20.89 | $21.38 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $81.28 Typical High $117.49 | Professional | 54 · Surgery only | $77.62 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.22 Typical High $23.44 | Professional | 55 · Aftercare only | $15.49 | $16.22 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.47 | $10.72 | $15.85 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 59 · Distinct service | $208.93 | $208.93 | $208.93 |
Where Oklahoma sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 18th of 51
$204
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.