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 $120.23 Median $7,585.78 Typical High $12,589.25 | Facility | None | $120.23 | $7,585.78 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $120.23 | Professional | None | $85.11 | $120.23 | $120.23 |
BCBS Nebraska Setting Facility Modifier None Typical Low $3,090.30 Median $4,168.69 Typical High $8,511.38 | Facility | None | $3,090.30 | $4,168.69 | $8,511.38 |
BCBS Nebraska Setting Professional Modifier None Typical Low $74.13 Median $131.83 Typical High $181.97 | Professional | None | $74.13 | $131.83 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $562.34 Typical High $630.96 | Facility | None | $467.74 | $562.34 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $309.03 | Professional | None | $199.53 | $257.04 | $309.03 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $660.69 Typical High $2,290.87 | Facility | None | $186.21 | $660.69 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $954.99 | Professional | None | $169.82 | $302.00 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $338.84 | Professional | None | $199.53 | $281.84 | $338.84 |
Midlands Setting Facility Modifier None Typical Low $457.09 Median $562.34 Typical High $741.31 | Facility | None | $457.09 | $562.34 | $741.31 |
Midlands Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $281.84 | Professional | None | $173.78 | $245.47 | $281.84 |
United Setting Facility Modifier None Typical Low $467.74 Median $812.83 Typical High $2,754.23 | Facility | None | $467.74 | $812.83 | $2,754.23 |
United Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $323.59 | Professional | None | $134.90 | $218.78 | $323.59 |
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 $42.66 Median $42.66 Typical High $60.26 | Professional | 52 · Reduced service | $42.66 | $42.66 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $23.99 | Professional | 53 · Discontinued | $16.98 | $16.98 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | 54 · Surgery only | $64.57 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $17.78 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $12.02 |
Where Nebraska sits
The same service costs 3.5 times more in Alaska than in Indiana. 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· 28th of 51
$166
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.