How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,096 to $10,000Professionalmedian $661 · 10th to 90th $339 to $1,413
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 $501.19 Median $7,244.36 Typical High $17,378.01 | Facility | None | $501.19 | $7,244.36 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $645.65 Typical High $1,318.26 | Professional | None | $338.84 | $645.65 | $1,318.26 |
BCBS Nebraska Setting Facility Modifier None Typical Low $7,079.46 Median $9,549.93 Typical High $19,054.61 | Facility | None | $7,079.46 | $9,549.93 | $19,054.61 |
BCBS Nebraska Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $724.44 | Professional | None | $295.12 | $524.81 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,995.26 Typical High $2,884.03 | Facility | None | $1,096.48 | $1,995.26 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,288.25 | Professional | None | $707.95 | $1,071.52 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $1,819.70 Typical High $7,943.28 | Facility | None | $851.14 | $1,819.70 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,288.25 Typical High $3,981.07 | Professional | None | $676.08 | $1,288.25 | $3,981.07 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,412.54 | Professional | None | $831.76 | $1,122.02 | $1,412.54 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $2,344.23 Typical High $3,019.95 | Facility | None | $1,096.48 | $2,344.23 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $1,122.02 Typical High $1,698.24 | Professional | None | $616.60 | $1,122.02 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $5,495.41 | Facility | None | $1,174.90 | $1,862.09 | $5,495.41 |
United Setting Professional Modifier None Typical Low $478.63 Median $812.83 Typical High $1,348.96 | Professional | None | $478.63 | $812.83 | $1,348.96 |
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 $169.82 Median $245.47 Typical High $281.84 | Professional | 52 · Reduced service | $169.82 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $100.00 Typical High $112.20 | Professional | 53 · Discontinued | $67.61 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $371.54 Typical High $426.58 | Professional | 54 · Surgery only | $251.19 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $74.13 Typical High $85.11 | Professional | 55 · Aftercare only | $50.12 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $50.12 Typical High $56.23 | Professional | 56 · Pre-op care only | $33.88 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $346.74 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $234.42 | $346.74 | $398.11 |
Where Nebraska sits
The same service costs 4.7 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 $6,438MT $1,383
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.