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 $302.00 Median $7,585.78 Typical High $12,589.25 | Facility | None | $302.00 | $7,585.78 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $302.00 Typical High $741.31 | Professional | None | $131.83 | $302.00 | $741.31 |
BCBS Nebraska Setting Facility Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,698.24 | $3,467.37 |
BCBS Nebraska Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $263.03 | Professional | None | $114.82 | $194.98 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $199.53 | Facility | None | $131.83 | $165.96 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $524.81 Typical High $794.33 | Professional | None | $263.03 | $524.81 | $794.33 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $245.47 Typical High $1,778.28 | Facility | None | $102.33 | $245.47 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $691.83 Typical High $2,570.40 | Professional | None | $363.08 | $691.83 | $2,570.40 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $616.60 Typical High $933.25 | Professional | None | $309.03 | $616.60 | $933.25 |
Midlands Setting Facility Modifier None Typical Low $131.83 Median $169.82 Typical High $204.17 | Facility | None | $131.83 | $169.82 | $204.17 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $575.44 Typical High $1,096.48 | Professional | None | $239.88 | $575.44 | $1,096.48 |
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 $181.97 Median $363.08 Typical High $741.31 | Professional | None | $181.97 | $363.08 | $741.31 |
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 $64.57 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $64.57 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $26.30 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $97.72 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $19.50 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $13.18 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $213.80 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $91.20 | $213.80 | $213.80 |
Where Nebraska sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 31st of 51
$257
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.