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 $630.96 Median $2,511.89 Typical High $7,585.78 | Facility | None | $630.96 | $2,511.89 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $162.18 Typical High $169.82 | Professional | None | $158.49 | $162.18 | $169.82 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $794.33 Median $3,090.30 Typical High $5,248.07 | Facility | None | $794.33 | $3,090.30 | $5,248.07 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $204.17 | Professional | None | $141.25 | $190.55 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $114.82 Typical High $467.74 | Facility | None | $95.50 | $114.82 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $229.09 | Professional | None | $165.96 | $177.83 | $229.09 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $218.78 Typical High $5,495.41 | Facility | None | $169.82 | $218.78 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $1,122.02 Typical High $2,187.76 | Professional | None | $138.04 | $1,122.02 | $2,187.76 |
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 $125.89 Median $151.36 Typical High $194.98 | Professional | None | $125.89 | $151.36 | $194.98 |
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 $79.43 Median $79.43 Typical High $85.11 | Professional | 52 · Reduced service | $79.43 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $32.36 Typical High $33.88 | Professional | 53 · Discontinued | $31.62 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | 54 · Surgery only | $120.23 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $25.70 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.22 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.85 | $16.22 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $112.20 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $112.20 | $112.20 | $120.23 |
Where Oklahoma sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$195
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.