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 $275.42 Median $446.68 Typical High $467.74 | Professional | None | $275.42 | $446.68 | $467.74 |
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 $239.88 Median $416.87 Typical High $575.44 | Professional | None | $239.88 | $416.87 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $190.55 Typical High $218.78 | Facility | None | $66.07 | $190.55 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $467.74 | Professional | None | $281.84 | $426.58 | $467.74 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $524.81 Typical High $1,548.82 | Facility | None | $100.00 | $524.81 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $2,630.27 Typical High $4,168.69 | Professional | None | $389.05 | $2,630.27 | $4,168.69 |
United Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $1,380.38 | Facility | None | $89.13 | $616.60 | $1,380.38 |
United Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $501.19 | Professional | None | $223.87 | $354.81 | $501.19 |
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 $134.90 Median $141.25 Typical High $234.42 | Professional | 52 · Reduced service | $134.90 | $141.25 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $56.23 Typical High $95.50 | Professional | 53 · Discontinued | $54.95 | $56.23 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $208.93 Typical High $354.81 | Professional | 54 · Surgery only | $204.17 | $208.93 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $41.69 Typical High $70.79 | Professional | 55 · Aftercare only | $40.74 | $41.69 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.18 Typical High $46.77 | Professional | 56 · Pre-op care only | $27.54 | $28.18 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $194.98 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $190.55 | $194.98 | $331.13 |
Where Oklahoma sits
The same service costs 3.4 times more in Alaska than in Maryland. 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
$468
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.