How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,288 to $8,913Professionalmedian $1,995 · 10th to 90th $1,072 to $2,754
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 $812.83 Median $812.83 Typical High $1,380.38 | Professional | None | $812.83 | $812.83 | $1,380.38 |
BCBS Nebraska Setting Facility Modifier None Typical Low $4,365.16 Median $5,888.44 Typical High $11,748.98 | Facility | None | $4,365.16 | $5,888.44 | $11,748.98 |
BCBS Nebraska Setting Professional Modifier None Typical Low $2,290.87 Median $2,454.71 Typical High $2,570.40 | Professional | None | $2,290.87 | $2,454.71 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,344.23 Typical High $2,884.03 | Facility | None | $1,288.25 | $2,344.23 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,137.96 | Professional | None | $1,659.59 | $1,949.84 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $2,290.87 Typical High $8,912.51 | Facility | None | $1,148.15 | $2,290.87 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $2,041.74 Typical High $6,760.83 | Professional | None | $1,071.52 | $2,041.74 | $6,760.83 |
Midlands Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,630.27 | Professional | None | $1,659.59 | $1,995.26 | $2,630.27 |
Midlands Setting Facility Modifier None Typical Low $1,288.25 Median $2,398.83 Typical High $3,019.95 | Facility | None | $1,288.25 | $2,398.83 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $2,754.23 | Professional | None | $1,513.56 | $2,089.30 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,238.72 Typical High $6,309.57 | Facility | None | $1,288.25 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,778.28 | $2,344.23 |
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 $407.38 Median $407.38 Typical High $691.83 | Professional | 52 · Reduced service | $407.38 | $407.38 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $275.42 | Professional | 53 · Discontinued | $162.18 | $162.18 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $1,047.13 | Professional | 54 · Surgery only | $616.60 | $616.60 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $208.93 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $138.04 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $977.24 |
Where Nebraska sits
The same service costs 3.0 times more in Wisconsin 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
WI $7,993MD $2,690
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.