How much rates vary
Facilitymedian $1,479 · 10th to 90th $832 to $6,026Professionalmedian $1,000 · 10th to 90th $537 to $1,380
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 $912.01 Median $3,235.94 Typical High $11,481.54 | Facility | None | $912.01 | $3,235.94 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $912.01 | Professional | None | $416.87 | $416.87 | $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 $1,202.26 Median $1,288.25 Typical High $1,380.38 | Professional | None | $1,202.26 | $1,288.25 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,584.89 | Facility | None | $954.99 | $1,318.26 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,096.48 | Professional | None | $831.76 | $1,000.00 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $1,348.96 Typical High $4,786.30 | Facility | None | $707.95 | $1,348.96 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $1,023.29 Typical High $4,365.16 | Professional | None | $537.03 | $1,023.29 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,318.26 | Professional | None | $831.76 | $1,000.00 | $1,318.26 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,621.81 | Facility | None | $954.99 | $1,318.26 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,380.38 | Professional | None | $776.25 | $1,047.13 | $1,380.38 |
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 $537.03 Median $891.25 Typical High $1,202.26 | Professional | None | $537.03 | $891.25 | $1,202.26 |
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 $208.93 Median $208.93 Typical High $354.81 | Professional | 52 · Reduced service | $208.93 | $208.93 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $141.25 | Professional | 53 · Discontinued | $83.18 | $83.18 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $537.03 | Professional | 54 · Surgery only | $316.23 | $316.23 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $107.15 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $70.79 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $501.19 |
Where Nebraska sits
The same service costs 3.9 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 $4,996MD $1,270
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.