How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,514 to $11,749Professionalmedian $1,514 · 10th to 90th $646 to $7,244
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 $4,168.69 Median $7,244.36 Typical High $17,378.01 | Facility | None | $4,168.69 | $7,244.36 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,412.54 Typical High $1,698.24 | Professional | None | $645.65 | $1,412.54 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $1,513.56 | Professional | None | $204.17 | $354.81 | $1,513.56 |
BCBS Nebraska Setting Facility Modifier None Typical Low $8,128.31 Median $10,715.19 Typical High $21,877.62 | Facility | None | $8,128.31 | $10,715.19 | $21,877.62 |
BCBS Nebraska Setting Professional Modifier None Typical Low $6,918.31 Median $7,244.36 Typical High $7,585.78 | Professional | None | $6,918.31 | $7,244.36 | $7,585.78 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $6,025.60 Typical High $8,511.38 | Facility | None | $1,096.48 | $6,025.60 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,548.82 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $1,479.11 Median $3,981.07 Typical High $26,302.68 | Facility | None | $1,479.11 | $3,981.07 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $1,621.81 Typical High $7,244.36 | Professional | None | $870.96 | $1,621.81 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,621.81 | $2,137.96 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $6,760.83 Typical High $8,912.51 | Facility | None | $1,096.48 | $6,760.83 | $8,912.51 |
Midlands Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,621.81 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,981.07 Typical High $8,912.51 | Facility | None | $1,698.24 | $3,981.07 | $8,912.51 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,412.54 Typical High $1,949.84 | Professional | None | $870.96 | $1,412.54 | $1,949.84 |
7 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 $323.59 Median $323.59 Typical High $549.54 | Professional | 52 · Reduced service | $323.59 | $323.59 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $223.87 | Professional | 53 · Discontinued | $131.83 | $131.83 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $831.76 | Professional | 54 · Surgery only | $489.78 | $489.78 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $165.96 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $109.65 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $776.25 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 80 · Assistant surgeon | $48.98 | $48.98 | $48.98 |
Where Nebraska sits
The same service costs 6.1 times more in Colorado 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
CO $13,882MT $2,270
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.