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 $56.23 Median $3,388.44 Typical High $11,481.54 | Facility | None | $56.23 | $3,388.44 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $72.44 Typical High $117.49 | Professional | None | $33.88 | $72.44 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $100.00 | Professional | None | $57.54 | $57.54 | $100.00 |
BCBS Nebraska Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $1,905.46 | Facility | None | $691.83 | $933.25 | $1,905.46 |
BCBS Nebraska Setting Professional Modifier None Typical Low $30.20 Median $51.29 Typical High $67.61 | Professional | None | $30.20 | $51.29 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $48.98 Typical High $61.66 | Facility | None | $40.74 | $48.98 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $125.89 | Professional | None | $75.86 | $104.71 | $125.89 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $213.80 Typical High $2,511.89 | Facility | None | $64.57 | $213.80 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $67.61 Median $128.82 Typical High $616.60 | Professional | None | $67.61 | $128.82 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $128.82 | Professional | None | $89.13 | $117.49 | $128.82 |
Midlands Setting Facility Modifier None Typical Low $40.74 Median $50.12 Typical High $67.61 | Facility | None | $40.74 | $50.12 | $67.61 |
Midlands Setting Professional Modifier None Typical Low $61.66 Median $117.49 Typical High $165.96 | Professional | None | $61.66 | $117.49 | $165.96 |
Oscar Health Setting Professional Modifier None Typical Low $38.90 Median $70.79 Typical High $109.65 | Professional | None | $38.90 | $70.79 | $109.65 |
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 $51.29 Median $83.18 Typical High $138.04 | Professional | None | $51.29 | $83.18 | $138.04 |
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 $16.98 Median $23.99 Typical High $28.18 | Professional | 52 · Reduced service | $16.98 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $9.77 Typical High $11.48 | Professional | 53 · Discontinued | $6.76 | $9.77 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $36.31 Typical High $42.66 | Professional | 54 · Surgery only | $25.12 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $7.24 Typical High $8.51 | Professional | 55 · Aftercare only | $5.01 | $7.24 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.79 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.39 | $4.79 | $5.75 |
Where Nebraska sits
The same service costs 4.2 times more in Alaska than in New York. 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· 17th of 51
$67.61
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.