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 $3,981.07 Typical High $12,589.25 | Facility | None | $1,000.00 | $3,981.07 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $346.74 | Professional | None | $208.93 | $338.84 | $346.74 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $407.38 | Professional | None | $186.21 | $302.00 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $309.03 Typical High $467.74 | Facility | None | $251.19 | $309.03 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $398.11 | Professional | None | $218.78 | $331.13 | $398.11 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $489.78 Typical High $5,495.41 | Facility | None | $269.15 | $489.78 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $1,479.11 Typical High $3,235.94 | Professional | None | $281.84 | $1,479.11 | $3,235.94 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $6,165.95 | Facility | None | $933.25 | $2,951.21 | $6,165.95 |
United Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $363.08 | Professional | None | $169.82 | $263.03 | $363.08 |
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 $104.71 Median $109.65 Typical High $169.82 | Professional | 52 · Reduced service | $104.71 | $109.65 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $43.65 Typical High $69.18 | Professional | 53 · Discontinued | $41.69 | $43.65 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $165.96 Typical High $257.04 | Professional | 54 · Surgery only | $158.49 | $165.96 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.11 Typical High $51.29 | Professional | 55 · Aftercare only | $31.62 | $33.11 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.88 Typical High $34.67 | Professional | 56 · Pre-op care only | $20.89 | $21.88 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $154.88 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $147.91 | $154.88 | $239.88 |
Where Oklahoma sits
The same service costs 4.3 times more in Wyoming 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· 30th 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.