How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,148 to $8,913Professionalmedian $1,023 · 10th to 90th $550 to $2,570
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 $4,365.16 Median $7,244.36 Typical High $17,378.01 | Facility | None | $4,365.16 | $7,244.36 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $1,380.38 | Professional | None | $426.58 | $426.58 | $1,380.38 |
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 $4,570.88 Median $6,165.95 Typical High $12,302.69 | Facility | None | $4,570.88 | $6,165.95 | $12,302.69 |
BCBS Nebraska Setting Professional Modifier None Typical Low $2,290.87 Median $2,454.71 Typical High $2,570.40 | Professional | None | $2,290.87 | $2,454.71 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,344.23 Typical High $2,884.03 | Facility | None | $1,096.48 | $2,344.23 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,096.48 | Professional | None | $851.14 | $1,000.00 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $8,912.51 | Facility | None | $1,071.52 | $2,137.96 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,023.29 Typical High $3,388.44 | Professional | None | $549.54 | $1,023.29 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,348.96 | Professional | None | $851.14 | $1,023.29 | $1,348.96 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $2,398.83 Typical High $3,019.95 | Facility | None | $1,096.48 | $2,398.83 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,412.54 | Professional | None | $776.25 | $1,071.52 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,238.72 Typical High $6,309.57 | Facility | None | $1,288.25 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $549.54 Median $912.01 Typical High $1,230.27 | Professional | None | $549.54 | $912.01 | $1,230.27 |
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 $208.93 Median $208.93 Typical High $354.81 | Professional | 52 · Reduced service | $208.93 | $208.93 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $144.54 | Professional | 53 · Discontinued | $85.11 | $85.11 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $537.03 | Professional | 54 · Surgery only | $316.23 | $316.23 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $107.15 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $70.79 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $501.19 |
Where Nebraska sits
The same service costs 4.9 times more in Wisconsin than in Montana. 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
WI $7,341MT $1,483
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.