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 $251.19 Median $323.59 Typical High $323.59 | Professional | None | $251.19 | $323.59 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $275.42 Median $1,230.27 Typical High $2,137.96 | Facility | None | $275.42 | $1,230.27 | $2,137.96 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $389.05 | Professional | None | $223.87 | $302.00 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $239.88 Typical High $467.74 | Facility | None | $199.53 | $239.88 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $426.58 | Professional | None | $263.03 | $323.59 | $426.58 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $416.87 Typical High $2,398.83 | Facility | None | $263.03 | $416.87 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $2,818.38 | Professional | None | $263.03 | $416.87 | $2,818.38 |
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 $204.17 Median $288.40 Typical High $426.58 | Professional | None | $204.17 | $288.40 | $426.58 |
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 $125.89 Median $131.83 Typical High $162.18 | Professional | 52 · Reduced service | $125.89 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $64.57 | Professional | 53 · Discontinued | $50.12 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $194.98 Typical High $245.47 | Professional | 54 · Surgery only | $190.55 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.90 Typical High $48.98 | Professional | 55 · Aftercare only | $38.02 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $181.97 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $177.83 | $181.97 | $229.09 |
Where Oklahoma sits
The same service costs 4.2 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· 35th of 51
$339
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.