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 $169.82 Median $269.15 Typical High $309.03 | Professional | None | $169.82 | $269.15 | $309.03 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $489.78 Median $2,511.89 Typical High $4,365.16 | Facility | None | $489.78 | $2,511.89 | $4,365.16 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $147.91 Median $269.15 Typical High $371.54 | Professional | None | $147.91 | $269.15 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $251.19 Typical High $467.74 | Facility | None | $208.93 | $251.19 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $302.00 | Professional | None | $173.78 | $263.03 | $302.00 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $380.19 Typical High $3,467.37 | Facility | None | $223.87 | $380.19 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $1,174.90 Typical High $2,238.72 | Professional | None | $251.19 | $1,174.90 | $2,238.72 |
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 $138.04 Median $229.09 Typical High $316.23 | Professional | None | $138.04 | $229.09 | $316.23 |
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 $85.11 Median $87.10 Typical High $151.36 | Professional | 52 · Reduced service | $85.11 | $87.10 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $34.67 Typical High $61.66 | Professional | 53 · Discontinued | $33.88 | $34.67 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $131.83 Typical High $229.09 | Professional | 54 · Surgery only | $125.89 | $131.83 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.30 Typical High $45.71 | Professional | 55 · Aftercare only | $25.12 | $26.30 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.38 Typical High $30.90 | Professional | 56 · Pre-op care only | $16.98 | $17.38 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $123.03 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $117.49 | $123.03 | $213.80 |
Where Oklahoma sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 16th of 51
$324
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.