How much rates vary
Facilitymedian $2,399 · 10th to 90th $1,072 to $7,244Professionalmedian $759 · 10th to 90th $407 to $1,318
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 $891.25 Median $4,365.16 Typical High $11,481.54 | Facility | None | $891.25 | $4,365.16 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $1,380.38 | Professional | None | $426.58 | $676.08 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,000.00 | Professional | None | $812.83 | $812.83 | $1,000.00 |
BCBS Nebraska Setting Facility Modifier None Typical Low $2,454.71 Median $3,467.37 Typical High $6,606.93 | Facility | None | $2,454.71 | $3,467.37 | $6,606.93 |
BCBS Nebraska Setting Professional Modifier None Typical Low $363.08 Median $645.65 Typical High $891.25 | Professional | None | $363.08 | $645.65 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,089.30 Typical High $2,818.38 | Facility | None | $1,096.48 | $2,089.30 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,122.02 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $2,089.30 Typical High $7,762.47 | Facility | None | $977.24 | $2,089.30 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,230.27 Typical High $4,168.69 | Professional | None | $676.08 | $1,230.27 | $4,168.69 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,230.27 | $1,548.82 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $2,187.76 Typical High $2,951.21 | Facility | None | $1,096.48 | $2,187.76 | $2,951.21 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,230.27 | Professional | None | $870.96 | $1,071.52 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $5,623.41 | Facility | None | $1,174.90 | $1,862.09 | $5,623.41 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,318.26 | Professional | None | $630.96 | $1,000.00 | $1,318.26 |
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 $213.80 Median $213.80 Typical High $263.03 | Professional | 52 · Reduced service | $213.80 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | 53 · Discontinued | $85.11 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $398.11 | Professional | 54 · Surgery only | $316.23 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $79.43 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $52.48 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $371.54 |
Where Nebraska sits
The same service costs 4.7 times more in Vermont than in Montana. 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.
Physician feeFacility fee
VT $7,643MT $1,633
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.