How much rates vary
Facilitymedian $1,514 · 10th to 90th $832 to $6,607Professionalmedian $851 · 10th to 90th $457 to $1,349
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 $512.86 Median $4,466.84 Typical High $11,481.54 | Facility | None | $512.86 | $4,466.84 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $912.01 | Professional | None | $457.09 | $512.86 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $537.03 | Professional | None | $436.52 | $537.03 | $537.03 |
BCBS Nebraska Setting Facility Modifier None Typical Low $3,388.44 Median $4,570.88 Typical High $9,120.11 | Facility | None | $3,388.44 | $4,570.88 | $9,120.11 |
BCBS Nebraska Setting Professional Modifier None Typical Low $407.38 Median $724.44 Typical High $1,000.00 | Professional | None | $407.38 | $724.44 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,584.89 | Facility | None | $954.99 | $1,318.26 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,348.96 | Professional | None | $954.99 | $1,122.02 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $1,258.93 Typical High $4,786.30 | Facility | None | $707.95 | $1,258.93 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $1,318.26 Typical High $4,073.80 | Professional | None | $660.69 | $1,318.26 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,230.27 | $1,513.56 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,698.24 | Facility | None | $954.99 | $1,318.26 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $1,479.11 Typical High $1,698.24 | Professional | None | $851.14 | $1,479.11 | $1,698.24 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $3,162.28 | Facility | None | $707.95 | $1,445.44 | $3,162.28 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,047.13 Typical High $1,348.96 | Professional | None | $645.65 | $1,047.13 | $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 $229.09 Median $257.04 Typical High $389.05 | Professional | 52 · Reduced service | $229.09 | $257.04 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $102.33 Typical High $154.88 | Professional | 53 · Discontinued | $91.20 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $588.84 | Professional | 54 · Surgery only | $346.74 | $380.19 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $77.62 Typical High $117.49 | Professional | 55 · Aftercare only | $69.18 | $77.62 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $51.29 Typical High $77.62 | Professional | 56 · Pre-op care only | $45.71 | $51.29 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $549.54 |
Where Nebraska sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.