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 $239.88 Median $3,801.89 Typical High $11,481.54 | Facility | None | $239.88 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $239.88 Typical High $407.38 | Professional | None | $144.54 | $239.88 | $407.38 |
BCBS Nebraska Setting Facility Modifier None Typical Low $5,011.87 Median $6,606.93 Typical High $13,489.63 | Facility | None | $5,011.87 | $6,606.93 | $13,489.63 |
BCBS Nebraska Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $316.23 | Professional | None | $125.89 | $223.87 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,479.11 | Facility | None | $851.14 | $1,122.02 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $630.96 | Professional | None | $309.03 | $501.19 | $630.96 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $1,096.48 Typical High $3,715.35 | Facility | None | $275.42 | $1,096.48 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $645.65 Typical High $1,995.26 | Professional | None | $323.59 | $645.65 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $676.08 | Professional | None | $363.08 | $537.03 | $676.08 |
Midlands Setting Facility Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,621.81 | Facility | None | $870.96 | $1,202.26 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $831.76 | Professional | None | $269.15 | $478.63 | $831.76 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $3,162.28 | Facility | None | $707.95 | $1,445.44 | $3,162.28 |
United Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $645.65 | Professional | None | $204.17 | $363.08 | $645.65 |
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 $72.44 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $72.44 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $28.84 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $107.15 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $21.38 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $14.45 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $169.82 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $100.00 | $169.82 | $169.82 |
Where Nebraska sits
The same service costs 4.5 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.
Nebraska· 17th of 51
$302
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.