How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,698 to $11,482Professionalmedian $1,820 · 10th to 90th $1,023 to $6,166
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 $741.31 Median $7,943.28 Typical High $21,877.62 | Facility | None | $741.31 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,258.93 | Professional | None | $741.31 | $741.31 | $1,258.93 |
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 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $3,019.95 | Facility | None | $2,454.71 | $2,884.03 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,737.80 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $1,445.44 Median $3,090.30 Typical High $5,623.41 | Facility | None | $1,445.44 | $3,090.30 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $1,949.84 Typical High $6,165.95 | Professional | None | $1,023.29 | $1,949.84 | $6,165.95 |
Midlands Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,949.84 | $2,570.40 |
Midlands Setting Facility Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $4,265.80 | Facility | None | $2,454.71 | $2,884.03 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $1,348.96 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,819.70 | $2,630.27 |
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 $1,023.29 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,698.24 | $2,344.23 |
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 $371.54 Median $371.54 Typical High $630.96 | Professional | 52 · Reduced service | $371.54 | $371.54 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $251.19 | Professional | 53 · Discontinued | $147.91 | $147.91 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $954.99 | Professional | 54 · Surgery only | $549.54 | $549.54 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $190.55 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $125.89 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $891.25 |
Where Nebraska sits
The same service costs 5.0 times more in Alabama 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
AL $11,256KY $2,261
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.