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 $181.97 Median $4,466.84 Typical High $11,481.54 | Facility | None | $181.97 | $4,466.84 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $407.38 | Professional | None | $112.20 | $181.97 | $407.38 |
BCBS Nebraska Setting Facility Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $3,388.44 | Facility | None | $1,258.93 | $1,659.59 | $3,388.44 |
BCBS Nebraska Setting Professional Modifier None Typical Low $97.72 Median $173.78 Typical High $218.78 | Professional | None | $97.72 | $173.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $208.93 Typical High $245.47 | Facility | None | $165.96 | $208.93 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $467.74 | Professional | None | $263.03 | $380.19 | $467.74 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $245.47 Typical High $1,778.28 | Facility | None | $102.33 | $245.47 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $446.68 Typical High $1,778.28 | Professional | None | $251.19 | $446.68 | $1,778.28 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $489.78 | Professional | None | $269.15 | $389.05 | $489.78 |
Midlands Setting Facility Modifier None Typical Low $169.82 Median $213.80 Typical High $269.15 | Facility | None | $169.82 | $213.80 | $269.15 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $380.19 Typical High $436.52 | Professional | None | $229.09 | $380.19 | $436.52 |
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 $169.82 Median $295.12 Typical High $478.63 | Professional | None | $169.82 | $295.12 | $478.63 |
5 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 $91.20 | Professional | 52 · Reduced service | $56.23 | $56.23 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $36.31 | Professional | 53 · Discontinued | $22.39 | $22.39 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $138.04 | Professional | 54 · Surgery only | $85.11 | $85.11 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $27.54 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $18.20 |
Where Nebraska sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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· 36th of 51
$209
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.