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 $117.49 Median $177.83 Typical High $263.03 | Professional | None | $117.49 | $177.83 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $616.60 Median $1,023.29 Typical High $1,584.89 | Facility | None | $616.60 | $1,023.29 | $1,584.89 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $245.47 | Professional | None | $144.54 | $186.21 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $151.36 Typical High $173.78 | Facility | None | $66.07 | $151.36 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $251.19 | Professional | None | $134.90 | $194.98 | $251.19 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $263.03 Typical High $2,398.83 | Facility | None | $158.49 | $263.03 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $933.25 Typical High $1,380.38 | Professional | None | $173.78 | $933.25 | $1,380.38 |
United Setting Facility Modifier None Typical Low $269.15 Median $1,148.15 Typical High $2,454.71 | Facility | None | $269.15 | $1,148.15 | $2,454.71 |
United Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $269.15 | Professional | None | $109.65 | $173.78 | $269.15 |
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 $58.88 Median $58.88 Typical High $89.13 | Professional | 52 · Reduced service | $58.88 | $58.88 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $35.48 | Professional | 53 · Discontinued | $23.44 | $23.44 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $89.13 Typical High $134.90 | Professional | 54 · Surgery only | $87.10 | $89.13 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $26.92 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $17.78 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $83.18 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $81.28 | $83.18 | $125.89 |
Where Oklahoma sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 14th of 51
$245
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.