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 $134.90 Median $223.87 Typical High $251.19 | Professional | None | $134.90 | $223.87 | $251.19 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $616.60 Median $1,023.29 Typical High $1,621.81 | Facility | None | $616.60 | $1,023.29 | $1,621.81 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $302.00 | Professional | None | $169.82 | $275.42 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $194.98 Typical High $223.87 | Facility | None | $66.07 | $194.98 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $302.00 | Professional | None | $162.18 | $234.42 | $302.00 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $323.59 Typical High $2,398.83 | Facility | None | $169.82 | $323.59 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $1,071.52 Typical High $1,737.80 | Professional | None | $218.78 | $1,071.52 | $1,737.80 |
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 $128.82 Median $204.17 Typical High $331.13 | Professional | None | $128.82 | $204.17 | $331.13 |
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 $67.61 Median $69.18 Typical High $112.20 | Professional | 52 · Reduced service | $67.61 | $69.18 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $27.54 Typical High $44.67 | Professional | 53 · Discontinued | $26.92 | $27.54 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $165.96 | Professional | 54 · Surgery only | $102.33 | $102.33 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $33.88 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.80 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.49 | $13.80 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $95.50 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $95.50 | $95.50 | $154.88 |
Where Oklahoma sits
The same service costs 4.6 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· 11th of 51
$309
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.