How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,288 to $10,965Professionalmedian $1,318 · 10th to 90th $692 to $2,455
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 $1,174.90 Median $7,079.46 Typical High $12,589.25 | Facility | None | $1,174.90 | $7,079.46 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $954.99 Typical High $1,412.54 | Professional | None | $537.03 | $954.99 | $1,412.54 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | None | $933.25 | $1,258.93 | $1,258.93 |
BCBS Nebraska Setting Facility Modifier None Typical Low $8,317.64 Median $10,964.78 Typical High $22,387.21 | Facility | None | $8,317.64 | $10,964.78 | $22,387.21 |
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 $2,454.71 Typical High $4,073.80 | Facility | None | $1,288.25 | $2,454.71 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,288.25 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $1,445.44 Median $3,801.89 Typical High $8,912.51 | Facility | None | $1,445.44 | $3,801.89 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,318.26 Typical High $4,365.16 | Professional | None | $691.83 | $1,318.26 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,318.26 | $1,737.80 |
Midlands Setting Facility Modifier None Typical Low $1,288.25 Median $2,630.27 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,630.27 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,348.96 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $7,244.36 | Facility | None | $1,698.24 | $3,801.89 | $7,244.36 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,148.15 Typical High $1,584.89 | Professional | None | $691.83 | $1,148.15 | $1,584.89 |
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 $269.15 Median $269.15 Typical High $457.09 | Professional | 52 · Reduced service | $269.15 | $269.15 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $181.97 | Professional | 53 · Discontinued | $107.15 | $107.15 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $676.08 | Professional | 54 · Surgery only | $398.11 | $398.11 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $134.90 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $91.20 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $630.96 |
Where Nebraska sits
The same service costs 4.7 times more in Oklahoma than in Montana. 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
OK $8,820MT $1,888
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.