How much rates vary
Facilitymedian $1,479 · 10th to 90th $832 to $7,244Professionalmedian $1,096 · 10th to 90th $631 to $1,622
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 $1,071.52 Median $3,162.28 Typical High $11,481.54 | Facility | None | $1,071.52 | $3,162.28 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $1,071.52 Typical High $1,288.25 | Professional | None | $489.78 | $1,071.52 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
BCBS Nebraska Setting Facility Modifier None Typical Low $3,019.95 Median $3,981.07 Typical High $8,128.31 | Facility | None | $3,019.95 | $3,981.07 | $8,128.31 |
BCBS Nebraska Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,096.48 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,513.56 | Facility | None | $851.14 | $1,096.48 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,288.25 | Professional | None | $977.24 | $1,174.90 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $1,348.96 Typical High $3,981.07 | Facility | None | $724.44 | $1,348.96 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $630.96 Median $1,202.26 Typical High $4,365.16 | Professional | None | $630.96 | $1,202.26 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,584.89 | Professional | None | $977.24 | $1,202.26 | $1,584.89 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,621.81 | Facility | None | $954.99 | $1,122.02 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,621.81 | Professional | None | $912.01 | $1,202.26 | $1,621.81 |
Oscar Health Setting Facility Modifier None Typical Low $3,467.37 Median $7,079.46 Typical High $21,379.62 | Facility | None | $3,467.37 | $7,079.46 | $21,379.62 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $3,162.28 | Facility | None | $707.95 | $1,445.44 | $3,162.28 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,047.13 Typical High $1,445.44 | Professional | None | $630.96 | $1,047.13 | $1,445.44 |
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 $245.47 Median $245.47 Typical High $416.87 | Professional | 52 · Reduced service | $245.47 | $245.47 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $165.96 | Professional | 53 · Discontinued | $97.72 | $97.72 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $616.60 | Professional | 54 · Surgery only | $363.08 | $363.08 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $123.03 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $83.18 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $575.44 |
Where Nebraska sits
The same service costs 4.0 times more in Colorado than in Maryland. 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 $5,106MD $1,261
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.