How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,096 to $10,715Professionalmedian $1,072 · 10th to 90th $575 to $2,570
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 $7,244.36 Typical High $17,378.01 | Facility | None | $4,365.16 | $7,244.36 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $1,380.38 | Professional | None | $436.52 | $436.52 | $1,380.38 |
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 $2,290.87 Median $2,454.71 Typical High $2,570.40 | Professional | None | $2,290.87 | $2,454.71 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,995.26 Typical High $2,884.03 | Facility | None | $1,096.48 | $1,995.26 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,148.15 | Professional | None | $870.96 | $1,047.13 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $1,819.70 Typical High $8,912.51 | Facility | None | $977.24 | $1,819.70 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $1,071.52 Typical High $3,548.13 | Professional | None | $575.44 | $1,071.52 | $3,548.13 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,412.54 | Professional | None | $870.96 | $1,071.52 | $1,412.54 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $2,344.23 Typical High $3,019.95 | Facility | None | $1,096.48 | $2,344.23 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,479.11 | Professional | None | $812.83 | $1,071.52 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $5,495.41 | Facility | None | $1,174.90 | $1,862.09 | $5,495.41 |
United Setting Professional Modifier None Typical Low $575.44 Median $954.99 Typical High $1,288.25 | Professional | None | $575.44 | $954.99 | $1,288.25 |
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 $218.78 Median $218.78 Typical High $371.54 | Professional | 52 · Reduced service | $218.78 | $218.78 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $147.91 | Professional | 53 · Discontinued | $87.10 | $87.10 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $562.34 | Professional | 54 · Surgery only | $331.13 | $331.13 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $112.20 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $74.13 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $524.81 |
Where Nebraska sits
The same service costs 4.6 times more in Alabama than in Montana. 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
AL $7,006MT $1,517
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.