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 $93.33 Median $3,801.89 Typical High $11,481.54 | Facility | None | $93.33 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $93.33 Typical High $245.47 | Professional | None | $51.29 | $93.33 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
BCBS Nebraska Setting Facility Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $3,388.44 | Facility | None | $1,258.93 | $1,659.59 | $3,388.44 |
BCBS Nebraska Setting Professional Modifier None Typical Low $44.67 Median $77.62 Typical High $100.00 | Professional | None | $44.67 | $77.62 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $109.65 Typical High $173.78 | Facility | None | $87.10 | $109.65 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $239.88 | Professional | None | $120.23 | $194.98 | $239.88 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $234.42 Typical High $1,288.25 | Facility | None | $93.33 | $234.42 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $758.58 | Professional | None | $123.03 | $229.09 | $758.58 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $251.19 | Professional | None | $123.03 | $199.53 | $251.19 |
Midlands Setting Facility Modifier None Typical Low $89.13 Median $112.20 Typical High $173.78 | Facility | None | $89.13 | $112.20 | $173.78 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $190.55 Typical High $218.78 | Professional | None | $104.71 | $190.55 | $218.78 |
United Setting Facility Modifier None Typical Low $104.71 Median $251.19 Typical High $1,230.27 | Facility | None | $104.71 | $251.19 | $1,230.27 |
United Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $309.03 | Professional | None | $79.43 | $138.04 | $309.03 |
5 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 $25.70 Median $25.70 Typical High $46.77 | Professional | 52 · Reduced service | $25.70 | $25.70 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $18.62 | Professional | 53 · Discontinued | $10.23 | $10.23 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $38.02 Typical High $70.79 | Professional | 54 · Surgery only | $38.02 | $38.02 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $14.13 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $9.33 |
Where Nebraska sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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.
Nebraska· 46th of 51
$100
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.