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 $630,957.34 Median $851,138.04 Typical High $851,138.04 | Facility | None | $630,957.34 | $851,138.04 | $851,138.04 |
Aetna Setting Professional Modifier None Typical Low $588,843.66 Median $630,957.34 Typical High $630,957.34 | Professional | None | $588,843.66 | $630,957.34 | $630,957.34 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $24,547.09 Median $39,810.72 Typical High $61,659.50 | Facility | None | $24,547.09 | $39,810.72 | $61,659.50 |
Medica Setting Facility Modifier None Typical Low $537,031.80 Median $691,830.97 Typical High $933,254.30 | Facility | None | $537,031.80 | $691,830.97 | $933,254.30 |
Medica Setting Professional Modifier None Typical Low $977,237.22 Median $977,237.22 Typical High $977,237.22 | Professional | None | $977,237.22 | $977,237.22 | $977,237.22 |
United Setting Facility Modifier None Typical Low $575,439.94 Median $575,439.94 Typical High $575,439.94 | Facility | None | $575,439.94 | $575,439.94 | $575,439.94 |
United Setting Professional Modifier None Typical Low $562,341.33 Median $676,082.98 Typical High $794,328.23 | Professional | None | $562,341.33 | $676,082.98 | $794,328.23 |
4 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 $295,120.92 Median $316,227.77 Typical High $316,227.77 | Professional | 52 · Reduced service | $295,120.92 | $316,227.77 | $316,227.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117,489.76 Median $125,892.54 Typical High $125,892.54 | Professional | 53 · Discontinued | $117,489.76 | $125,892.54 | $125,892.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87,096.36 Median $93,325.43 Typical High $93,325.43 | Professional | 55 · Aftercare only | $87,096.36 | $93,325.43 | $93,325.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58,884.37 Median $63,095.73 Typical High $63,095.73 | Professional | 56 · Pre-op care only | $58,884.37 | $63,095.73 | $63,095.73 |
Where Oklahoma sits
The same service costs 1.7 times more in Texas than in Minnesota. 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· 2nd of 51
$794,328
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.