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 $125.89 Median $151.36 Typical High $158.49 | Professional | None | $125.89 | $151.36 | $158.49 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $100.00 Median $165.96 Typical High $245.47 | Facility | None | $100.00 | $165.96 | $245.47 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $190.55 | Professional | None | $109.65 | $151.36 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $125.89 | Facility | None | $66.07 | $107.15 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $190.55 | Professional | None | $131.83 | $158.49 | $190.55 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $199.53 Typical High $1,174.90 | Facility | None | $95.50 | $199.53 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $870.96 Typical High $1,148.15 | Professional | None | $128.82 | $870.96 | $1,148.15 |
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 $102.33 Median $128.82 Typical High $173.78 | Professional | None | $102.33 | $128.82 | $173.78 |
7 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 $63.10 Median $66.07 Typical High $79.43 | Professional | 52 · Reduced service | $63.10 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.30 Typical High $31.62 | Professional | 53 · Discontinued | $25.12 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $97.72 Typical High $120.23 | Professional | 54 · Surgery only | $95.50 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.50 Typical High $23.99 | Professional | 55 · Aftercare only | $19.05 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.59 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $91.20 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $89.13 | $91.20 | $112.20 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 50 · Both sides | $186.21 | $186.21 | $186.21 |
Where Oklahoma sits
The same service costs 4.1 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· 32nd of 51
$158
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.