How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,380 to $11,482Professionalmedian $1,862 · 10th to 90th $1,000 to $5,754
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 $4,365.16 Median $7,943.28 Typical High $21,877.62 | Facility | None | $4,365.16 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,445.44 Typical High $1,995.26 | Professional | None | $758.58 | $1,445.44 | $1,995.26 |
BCBS Nebraska Setting Facility Modifier None Typical Low $7,413.10 Median $10,000.00 Typical High $20,417.38 | Facility | None | $7,413.10 | $10,000.00 | $20,417.38 |
BCBS Nebraska Setting Professional Modifier None Typical Low $5,011.87 Median $5,370.32 Typical High $5,754.40 | Professional | None | $5,011.87 | $5,370.32 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $4,570.88 Typical High $6,456.54 | Facility | None | $1,380.38 | $4,570.88 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,778.28 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $1,318.26 Median $3,162.28 Typical High $19,952.62 | Facility | None | $1,318.26 | $3,162.28 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $6,025.60 | Professional | None | $1,000.00 | $1,862.09 | $6,025.60 |
Midlands Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,479.11 | $1,862.09 | $2,454.71 |
Midlands Setting Facility Modifier None Typical Low $1,380.38 Median $5,128.61 Typical High $6,760.83 | Facility | None | $1,380.38 | $5,128.61 | $6,760.83 |
Midlands Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,862.09 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $3,162.28 Typical High $8,912.51 | Facility | None | $1,380.38 | $3,162.28 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,659.59 | $2,238.72 |
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 $371.54 Median $371.54 Typical High $645.65 | Professional | 52 · Reduced service | $371.54 | $371.54 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $257.04 | Professional | 53 · Discontinued | $151.36 | $151.36 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $954.99 | Professional | 54 · Surgery only | $562.34 | $562.34 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $190.55 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $128.82 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $891.25 |
Where Nebraska sits
The same service costs 5.9 times more in Colorado than in West Virginia. 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
CO $14,031WV $2,390
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.