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 $3,162.28 Typical High $8,317.64 | Facility | None | $1,000.00 | $3,162.28 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $3,890.45 Median $6,456.54 Typical High $10,000.00 | Facility | None | $3,890.45 | $6,456.54 | $10,000.00 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $239.88 | Professional | None | $173.78 | $234.42 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $1,258.93 | Facility | None | $478.63 | $602.56 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $257.04 | Professional | None | $199.53 | $218.78 | $257.04 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $257.04 Typical High $3,388.44 | Facility | None | $100.00 | $257.04 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $1,318.26 | Professional | None | $162.18 | $208.93 | $1,318.26 |
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 $151.36 Median $190.55 Typical High $257.04 | Professional | None | $151.36 | $190.55 | $257.04 |
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 $81.28 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $123.03 Typical High $123.03 | Professional | 54 · Surgery only | $120.23 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $23.99 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $16.22 |
Where Oklahoma sits
The same service costs 4.5 times more in Alaska than in New York. 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· 26th of 51
$234
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.