How much rates vary
Facilitymedian $1,820 · 10th to 90th $240 to $7,079Professionalmedian $129 · 10th to 90th $68 to $407
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 $151.36 Median $1,548.82 Typical High $10,964.78 | Facility | None | $151.36 | $1,548.82 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $162.18 Typical High $426.58 | Professional | None | $69.18 | $162.18 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $147.91 | Professional | None | $91.20 | $107.15 | $147.91 |
BCBS Nebraska Setting Facility Modifier None Typical Low $4,677.35 Median $6,309.57 Typical High $12,589.25 | Facility | None | $4,677.35 | $6,309.57 | $12,589.25 |
BCBS Nebraska Setting Professional Modifier None Typical Low $61.66 Median $109.65 Typical High $147.91 | Professional | None | $61.66 | $109.65 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $1,862.09 Typical High $2,238.72 | Facility | None | $223.87 | $1,862.09 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $338.84 Typical High $416.87 | Professional | None | $165.96 | $338.84 | $416.87 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $1,318.26 Typical High $4,265.80 | Facility | None | $263.03 | $1,318.26 | $4,265.80 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $407.38 Typical High $1,318.26 | Professional | None | $213.80 | $407.38 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $354.81 Typical High $446.68 | Professional | None | $169.82 | $354.81 | $446.68 |
Midlands Setting Facility Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $3,019.95 | Facility | None | $1,479.11 | $2,041.74 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $144.54 Median $338.84 Typical High $389.05 | Professional | None | $144.54 | $338.84 | $389.05 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $3,801.89 | Facility | None | $707.95 | $1,445.44 | $3,801.89 |
United Setting Professional Modifier None Typical Low $114.82 Median $213.80 Typical High $426.58 | Professional | None | $114.82 | $213.80 | $426.58 |
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 $34.67 Median $34.67 Typical High $81.28 | Professional | 52 · Reduced service | $34.67 | $34.67 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $32.36 | Professional | 53 · Discontinued | $13.80 | $13.80 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $52.48 Typical High $123.03 | Professional | 54 · Surgery only | $52.48 | $52.48 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $24.55 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $16.22 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $16.22 |
Where Nebraska sits
The same service costs 9.7 times more in Colorado 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
CO $4,351MT $447
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.