How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,380 to $9,550Professionalmedian $741 · 10th to 90th $372 to $4,169
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 $1,584.89 Median $7,585.78 Typical High $19,952.62 | Facility | None | $1,584.89 | $7,585.78 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,445.44 Typical High $1,659.59 | Professional | None | $371.54 | $1,445.44 | $1,659.59 |
BCBS Nebraska Setting Facility Modifier None Typical Low $6,760.83 Median $8,912.51 Typical High $18,197.01 | Facility | None | $6,760.83 | $8,912.51 | $18,197.01 |
BCBS Nebraska Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $812.83 | Professional | None | $323.59 | $575.44 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $2,511.89 Typical High $3,019.95 | Facility | None | $1,949.84 | $2,511.89 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $3,311.31 Typical High $4,168.69 | Professional | None | $812.83 | $3,311.31 | $4,168.69 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $7,413.10 | Facility | None | $1,071.52 | $2,137.96 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $2,187.76 Median $4,365.16 Typical High $13,182.57 | Professional | None | $2,187.76 | $4,365.16 | $13,182.57 |
Midlands Setting Professional Modifier None Typical Low $954.99 Median $3,548.13 Typical High $4,365.16 | Professional | None | $954.99 | $3,548.13 | $4,365.16 |
Midlands Setting Facility Modifier None Typical Low $1,995.26 Median $2,630.27 Typical High $3,981.07 | Facility | None | $1,995.26 | $2,630.27 | $3,981.07 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $2,951.21 Typical High $5,888.44 | Professional | None | $691.83 | $2,951.21 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,238.72 Typical High $6,309.57 | Facility | None | $1,288.25 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $549.54 Median $2,187.76 Typical High $4,466.84 | Professional | None | $549.54 | $2,187.76 | $4,466.84 |
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 $186.21 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $186.21 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $74.13 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $275.42 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $56.23 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $37.15 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $257.04 | $1,096.48 | $1,096.48 |
Where Nebraska sits
The same service costs 4.4 times more in Oklahoma than in Maryland. 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
OK $10,373MD $2,367
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.