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 $97.72 Median $7,585.78 Typical High $12,589.25 | Facility | None | $97.72 | $7,585.78 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $257.04 | Professional | None | $74.13 | $125.89 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | None | $109.65 | $109.65 | $112.20 |
BCBS Nebraska Setting Facility Modifier None Typical Low $3,388.44 Median $4,570.88 Typical High $9,120.11 | Facility | None | $3,388.44 | $4,570.88 | $9,120.11 |
BCBS Nebraska Setting Professional Modifier None Typical Low $67.61 Median $114.82 Typical High $151.36 | Professional | None | $67.61 | $114.82 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $104.71 Typical High $169.82 | Facility | None | $83.18 | $104.71 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $257.04 | Professional | None | $154.88 | $199.53 | $257.04 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $239.88 Typical High $1,230.27 | Facility | None | $97.72 | $239.88 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $281.84 Typical High $1,023.29 | Professional | None | $125.89 | $281.84 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $263.03 | Professional | None | $181.97 | $234.42 | $263.03 |
Midlands Setting Facility Modifier None Typical Low $83.18 Median $107.15 Typical High $158.49 | Facility | None | $83.18 | $107.15 | $158.49 |
Midlands Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $323.59 | Professional | None | $138.04 | $257.04 | $323.59 |
United Setting Facility Modifier None Typical Low $104.71 Median $251.19 Typical High $1,230.27 | Facility | None | $104.71 | $251.19 | $1,230.27 |
United Setting Professional Modifier None Typical Low $107.15 Median $186.21 Typical High $269.15 | Professional | None | $107.15 | $186.21 | $269.15 |
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 $37.15 Median $48.98 Typical High $63.10 | Professional | 52 · Reduced service | $37.15 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.50 Typical High $25.12 | Professional | 53 · Discontinued | $15.14 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $72.44 Typical High $93.33 | Professional | 54 · Surgery only | $56.23 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $14.45 Typical High $18.62 | Professional | 55 · Aftercare only | $11.22 | $14.45 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.77 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.41 | $9.77 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $67.61 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $52.48 | $67.61 | $87.10 |
Where Nebraska sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 16th of 51
$141
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.