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 $194.98 Median $7,244.36 Typical High $12,589.25 | Facility | None | $194.98 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $512.86 | Professional | None | $114.82 | $194.98 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | None | $154.88 | $154.88 | $186.21 |
BCBS Nebraska Setting Facility Modifier None Typical Low $537.03 Median $707.95 Typical High $1,445.44 | Facility | None | $537.03 | $707.95 | $1,445.44 |
BCBS Nebraska Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $234.42 | Professional | None | $100.00 | $169.82 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $81.28 | Facility | None | $54.95 | $54.95 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $489.78 | Professional | None | $251.19 | $398.11 | $489.78 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $229.09 Typical High $1,288.25 | Facility | None | $102.33 | $229.09 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $436.52 Typical High $1,548.82 | Professional | None | $251.19 | $436.52 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $524.81 | Professional | None | $251.19 | $416.87 | $524.81 |
Midlands Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $81.28 | Facility | None | $54.95 | $54.95 | $81.28 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $457.09 | Professional | None | $234.42 | $398.11 | $457.09 |
United Setting Facility Modifier None Typical Low $104.71 Median $223.87 Typical High $1,230.27 | Facility | None | $104.71 | $223.87 | $1,230.27 |
United Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $501.19 | Professional | None | $158.49 | $281.84 | $501.19 |
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 $56.23 Median $56.23 Typical High $95.50 | Professional | 52 · Reduced service | $56.23 | $56.23 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $38.90 | Professional | 53 · Discontinued | $22.91 | $22.91 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $144.54 | Professional | 54 · Surgery only | $85.11 | $85.11 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $28.84 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $19.50 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $79.43 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $79.43 | $79.43 | $134.90 |
Where Nebraska sits
The same service costs 4.5 times more in Alaska 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.
Nebraska· 26th of 51
$214
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.