How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,820 to $11,482Professionalmedian $2,399 · 10th to 90th $1,349 to $8,318
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 $4,677.35 Median $7,943.28 Typical High $21,877.62 | Facility | None | $4,677.35 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,023.29 | $1,737.80 |
Ambetter Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
BCBS Nebraska Setting Facility Modifier None Typical Low $7,079.46 Median $9,332.54 Typical High $19,054.61 | Facility | None | $7,079.46 | $9,332.54 | $19,054.61 |
Cigna Setting Facility Modifier None Typical Low $7,413.10 Median $8,709.64 Typical High $9,120.11 | Facility | None | $7,413.10 | $8,709.64 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $2,691.53 | Professional | None | $1,995.26 | $2,454.71 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $1,513.56 Median $3,090.30 Typical High $8,128.31 | Facility | None | $1,513.56 | $3,090.30 | $8,128.31 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $2,570.40 Typical High $8,317.64 | Professional | None | $1,348.96 | $2,570.40 | $8,317.64 |
Midlands Setting Professional Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $3,388.44 | Professional | None | $1,995.26 | $2,570.40 | $3,388.44 |
Midlands Setting Facility Modifier None Typical Low $7,413.10 Median $8,709.64 Typical High $12,882.50 | Facility | None | $7,413.10 | $8,709.64 | $12,882.50 |
Midlands Setting Professional Modifier None Typical Low $1,905.46 Median $2,511.89 Typical High $3,467.37 | Professional | None | $1,905.46 | $2,511.89 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $8,912.51 | Facility | None | $1,698.24 | $3,801.89 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $2,238.72 Typical High $3,090.30 | Professional | None | $1,348.96 | $2,238.72 | $3,090.30 |
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 $512.86 Median $512.86 Typical High $870.96 | Professional | 52 · Reduced service | $512.86 | $512.86 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $346.74 | Professional | 53 · Discontinued | $204.17 | $204.17 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $776.25 | $776.25 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $263.03 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $173.78 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $1,230.27 |
Where Nebraska sits
The same service costs 5.1 times more in Alaska than in Kentucky. 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
AK $14,343KY $2,808
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.