How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,585 to $10,233Professionalmedian $1,380 · 10th to 90th $794 to $1,995
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 $575.44 Median $7,943.28 Typical High $21,877.62 | Facility | None | $575.44 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,000.00 | Professional | None | $575.44 | $575.44 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $776.25 Median $812.83 Typical High $870.96 | Professional | None | $776.25 | $812.83 | $870.96 |
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 $1,148.15 Median $1,380.38 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,380.38 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $3,090.30 Typical High $5,623.41 | Facility | None | $1,096.48 | $3,090.30 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,479.11 Typical High $4,786.30 | Professional | None | $794.33 | $1,479.11 | $4,786.30 |
Midlands Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,479.11 | $1,949.84 |
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 $1,071.52 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,445.44 | $1,995.26 |
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 $794.33 Median $1,288.25 Typical High $1,778.28 | Professional | None | $794.33 | $1,288.25 | $1,778.28 |
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 $288.40 Median $288.40 Typical High $489.78 | Professional | 52 · Reduced service | $288.40 | $288.40 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $199.53 | Professional | 53 · Discontinued | $114.82 | $114.82 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $741.31 | Professional | 54 · Surgery only | $436.52 | $436.52 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $147.91 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $100.00 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $691.83 |
Where Nebraska sits
The same service costs 7.6 times more in Oklahoma than in Texas. 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
OK $11,248TX $1,472
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.