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 $147.91 Median $288.40 Typical High $295.12 | Professional | None | $147.91 | $288.40 | $295.12 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $309.03 Median $549.54 Typical High $776.25 | Facility | None | $309.03 | $549.54 | $776.25 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $128.82 Median $257.04 Typical High $354.81 | Professional | None | $128.82 | $257.04 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $616.60 Typical High $776.25 | Facility | None | $512.86 | $616.60 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $288.40 | Professional | None | $154.88 | $223.87 | $288.40 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $380.19 Typical High $4,073.80 | Facility | None | $199.53 | $380.19 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $1,023.29 Typical High $2,884.03 | Professional | None | $239.88 | $1,023.29 | $2,884.03 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,995.26 Typical High $3,630.78 | Facility | None | $467.74 | $1,995.26 | $3,630.78 |
United Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $302.00 | Professional | None | $120.23 | $208.93 | $302.00 |
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 $72.44 Median $75.86 Typical High $147.91 | Professional | 52 · Reduced service | $72.44 | $75.86 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $30.20 Typical High $58.88 | Professional | 53 · Discontinued | $29.51 | $30.20 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $114.82 Typical High $218.78 | Professional | 54 · Surgery only | $109.65 | $114.82 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.91 Typical High $43.65 | Professional | 55 · Aftercare only | $21.88 | $22.91 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.14 Typical High $29.51 | Professional | 56 · Pre-op care only | $14.79 | $15.14 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $107.15 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $102.33 | $107.15 | $204.17 |
Where Oklahoma sits
The same service costs 4.7 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· 22nd of 51
$288
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.