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 $831.76 Median $3,090.30 Typical High $8,317.64 | Facility | None | $831.76 | $3,090.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $426.58 | Professional | None | $380.19 | $398.11 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $269.15 Median $1,230.27 Typical High $2,137.96 | Facility | None | $269.15 | $1,230.27 | $2,137.96 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $501.19 | Professional | None | $331.13 | $457.09 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $380.19 Typical High $630.96 | Facility | None | $309.03 | $380.19 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $478.63 | Professional | None | $371.54 | $426.58 | $478.63 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $549.54 Typical High $2,818.38 | Facility | None | $338.84 | $549.54 | $2,818.38 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $2,630.27 Typical High $2,884.03 | Professional | None | $338.84 | $2,630.27 | $2,884.03 |
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 $295.12 Median $363.08 Typical High $478.63 | Professional | None | $295.12 | $363.08 | $478.63 |
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 $190.55 Median $194.98 Typical High $208.93 | Professional | 52 · Reduced service | $190.55 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $85.11 | Professional | 53 · Discontinued | $75.86 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $295.12 Typical High $316.23 | Professional | 54 · Surgery only | $281.84 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $58.88 Typical High $63.10 | Professional | 55 · Aftercare only | $57.54 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.02 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $275.42 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $263.03 | $275.42 | $295.12 |
Where Oklahoma sits
The same service costs 5.6 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· 29th of 51
$447
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.