How much rates vary
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 $112.20 Median $3,801.89 Typical High $11,481.54 | Facility | None | $112.20 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $190.55 | Professional | None | $100.00 | $112.20 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
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 $87.10 Median $147.91 Typical High $199.53 | Professional | None | $87.10 | $147.91 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $138.04 Typical High $154.88 | Facility | None | $112.20 | $138.04 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $295.12 | Professional | None | $204.17 | $239.88 | $295.12 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $234.42 Typical High $1,288.25 | Facility | None | $102.33 | $234.42 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $281.84 Typical High $891.25 | Professional | None | $141.25 | $281.84 | $891.25 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $309.03 | Professional | None | $239.88 | $269.15 | $309.03 |
Midlands Setting Facility Modifier None Typical Low $112.20 Median $138.04 Typical High $165.96 | Facility | None | $112.20 | $138.04 | $165.96 |
Midlands Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $346.74 | Professional | None | $186.21 | $309.03 | $346.74 |
United Setting Facility Modifier None Typical Low $104.71 Median $251.19 Typical High $1,230.27 | Facility | None | $104.71 | $251.19 | $1,230.27 |
United Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $288.40 | Professional | None | $134.90 | $218.78 | $288.40 |
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 $50.12 Median $56.23 Typical High $83.18 | Professional | 52 · Reduced service | $50.12 | $56.23 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $22.91 Typical High $33.11 | Professional | 53 · Discontinued | $19.95 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $85.11 Typical High $125.89 | Professional | 54 · Surgery only | $74.13 | $85.11 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.98 Typical High $25.12 | Professional | 55 · Aftercare only | $14.79 | $16.98 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.22 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.00 | $11.22 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $79.43 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $69.18 | $79.43 | $117.49 |
Where Nebraska sits
The same service costs 4.5 times more in Alaska than in Florida. 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.
Nebraska· 12th of 51
$174
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.