How much rates vary
Facilitymedian $5,754 · 10th to 90th $2,291 to $11,220Professionalmedian $891 · 10th to 90th $457 to $15,488
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 $4,677.35 Median $7,943.28 Typical High $21,877.62 | Facility | None | $4,677.35 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $1,584.89 Typical High $8,128.31 | Professional | None | $457.09 | $1,584.89 | $8,128.31 |
Ambetter Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,023.29 | Professional | None | $549.54 | $549.54 | $1,023.29 |
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 $407.38 Median $724.44 Typical High $1,000.00 | Professional | None | $407.38 | $724.44 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $5,495.41 Typical High $7,244.36 | Facility | None | $4,168.69 | $5,495.41 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $10,232.93 Typical High $15,488.17 | Professional | None | $1,000.00 | $10,232.93 | $15,488.17 |
Medica Setting Facility Modifier None Typical Low $1,445.44 Median $3,981.07 Typical High $10,964.78 | Facility | None | $1,445.44 | $3,981.07 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $8,128.31 Median $17,378.01 Typical High $52,480.75 | Professional | None | $8,128.31 | $17,378.01 | $52,480.75 |
Midlands Setting Professional Modifier None Typical Low $1,174.90 Median $11,481.54 Typical High $15,488.17 | Professional | None | $1,174.90 | $11,481.54 | $15,488.17 |
Midlands Setting Facility Modifier None Typical Low $4,365.16 Median $5,888.44 Typical High $8,912.51 | Facility | None | $4,365.16 | $5,888.44 | $8,912.51 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $9,120.11 Typical High $18,620.87 | Professional | None | $851.14 | $9,120.11 | $18,620.87 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $8,912.51 | Facility | None | $1,698.24 | $3,801.89 | $8,912.51 |
United Setting Professional Modifier None Typical Low $676.08 Median $8,128.31 Typical High $16,218.10 | Professional | None | $676.08 | $8,128.31 | $16,218.10 |
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 $229.09 Median $2,454.71 Typical High $2,454.71 | Professional | 52 · Reduced service | $229.09 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $977.24 Typical High $977.24 | Professional | 53 · Discontinued | $91.20 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $3,715.35 Typical High $3,715.35 | Professional | 54 · Surgery only | $346.74 | $3,715.35 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $69.18 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $489.78 Typical High $489.78 | Professional | 56 · Pre-op care only | $45.71 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $3,467.37 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $323.59 | $3,467.37 | $3,467.37 |
Where Nebraska sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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 $20,151MS $3,493
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.