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 $257.04 Median $398.11 Typical High $407.38 | Professional | None | $257.04 | $398.11 | $407.38 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $4,570.88 | Facility | None | $1,778.28 | $2,951.21 | $4,570.88 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $489.78 | Professional | None | $223.87 | $354.81 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $302.00 Typical High $1,023.29 | Facility | None | $251.19 | $302.00 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $407.38 | Professional | None | $263.03 | $354.81 | $407.38 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $512.86 Typical High $5,495.41 | Facility | None | $309.03 | $512.86 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $1,737.80 Typical High $3,548.13 | Professional | None | $323.59 | $1,737.80 | $3,548.13 |
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 $208.93 Median $302.00 Typical High $416.87 | Professional | None | $208.93 | $302.00 | $416.87 |
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 $128.82 Median $131.83 Typical High $199.53 | Professional | 52 · Reduced service | $128.82 | $131.83 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $52.48 Typical High $81.28 | Professional | 53 · Discontinued | $51.29 | $52.48 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $194.98 Typical High $302.00 | Professional | 54 · Surgery only | $190.55 | $194.98 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.90 Typical High $60.26 | Professional | 55 · Aftercare only | $38.02 | $38.90 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.30 Typical High $40.74 | Professional | 56 · Pre-op care only | $25.70 | $26.30 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $181.97 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $177.83 | $181.97 | $281.84 |
Where Oklahoma sits
The same service costs 3.9 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· 20th of 51
$417
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.