How much rates vary
Facilitymedian $1,905 · 10th to 90th $1,072 to $8,128Professionalmedian $575 · 10th to 90th $288 to $1,175
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 $489.78 Median $6,606.93 Typical High $12,589.25 | Facility | None | $489.78 | $6,606.93 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $645.65 Typical High $1,122.02 | Professional | None | $288.40 | $645.65 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $562.34 | Professional | None | $512.86 | $562.34 | $562.34 |
BCBS Nebraska Setting Facility Modifier None Typical Low $4,786.30 Median $6,456.54 Typical High $12,882.50 | Facility | None | $4,786.30 | $6,456.54 | $12,882.50 |
BCBS Nebraska Setting Professional Modifier None Typical Low $257.04 Median $457.09 Typical High $630.96 | Professional | None | $257.04 | $457.09 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,995.26 | Facility | None | $1,071.52 | $1,318.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,122.02 | Professional | None | $616.60 | $933.25 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $4,786.30 | Facility | None | $831.76 | $1,819.70 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $1,122.02 Typical High $3,467.37 | Professional | None | $575.44 | $1,122.02 | $3,467.37 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,174.90 | Professional | None | $724.44 | $954.99 | $1,174.90 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,089.30 | Facility | None | $1,096.48 | $1,445.44 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $537.03 Median $954.99 Typical High $1,445.44 | Professional | None | $537.03 | $954.99 | $1,445.44 |
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 $407.38 Median $707.95 Typical High $1,174.90 | Professional | None | $407.38 | $707.95 | $1,174.90 |
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 $144.54 Median $213.80 Typical High $245.47 | Professional | 52 · Reduced service | $144.54 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $85.11 Typical High $97.72 | Professional | 53 · Discontinued | $58.88 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $323.59 Typical High $371.54 | Professional | 54 · Surgery only | $218.78 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $64.57 Typical High $74.13 | Professional | 55 · Aftercare only | $43.65 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $42.66 Typical High $48.98 | Professional | 56 · Pre-op care only | $28.84 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $302.00 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $204.17 | $302.00 | $346.74 |
Where Nebraska sits
The same service costs 5.2 times more in Colorado than in West Virginia. 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 $4,833WV $936
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.