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 $5,011.87 Median $7,943.28 Typical High $19,952.62 | Facility | None | $5,011.87 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,000.00 | $1,698.24 |
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 |
Cigna Setting Facility Modifier None Typical Low $14,125.38 Median $16,595.87 Typical High $17,378.01 | Facility | None | $14,125.38 | $16,595.87 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,187.76 Typical High $2,570.40 | Professional | None | $2,041.74 | $2,187.76 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $1,445.44 Median $3,090.30 Typical High $6,456.54 | Facility | None | $1,445.44 | $3,090.30 | $6,456.54 |
Medica Setting Professional Modifier None Typical Low $1,258.93 Median $2,398.83 Typical High $8,128.31 | Professional | None | $1,258.93 | $2,398.83 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $3,162.28 | Professional | None | $2,041.74 | $2,398.83 | $3,162.28 |
Midlands Setting Facility Modifier None Typical Low $14,125.38 Median $16,595.87 Typical High $24,547.09 | Facility | None | $14,125.38 | $16,595.87 | $24,547.09 |
Midlands Setting Professional Modifier None Typical Low $1,819.70 Median $2,570.40 Typical High $3,388.44 | Professional | None | $1,819.70 | $2,570.40 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $9,772.37 | Facility | None | $1,698.24 | $3,801.89 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,258.93 | $2,137.96 | $2,884.03 |
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 $501.19 Median $501.19 Typical High $851.14 | Professional | 52 · Reduced service | $501.19 | $501.19 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $338.84 | Professional | 53 · Discontinued | $199.53 | $199.53 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $1,258.93 | Professional | 54 · Surgery only | $741.31 | $741.31 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $251.19 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $169.82 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $1,174.90 |
Where Nebraska sits
The same service costs 46.8 times more in Alaska than in Hawaii. 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· 4th of 51
$2,399
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.