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 $275.42 Median $4,466.84 Typical High $11,481.54 | Facility | None | $275.42 | $4,466.84 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $1,445.44 | Professional | None | $190.55 | $275.42 | $1,445.44 |
BCBS Nebraska Setting Facility Modifier None Typical Low $6,025.60 Median $8,128.31 Typical High $16,218.10 | Facility | None | $6,025.60 | $8,128.31 | $16,218.10 |
BCBS Nebraska Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $398.11 | Professional | None | $162.18 | $288.40 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $512.86 Typical High $954.99 | Facility | None | $380.19 | $512.86 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $707.95 | Professional | None | $446.68 | $602.56 | $707.95 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $269.15 Typical High $1,995.26 | Facility | None | $114.82 | $269.15 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $2,187.76 | Professional | None | $426.58 | $691.83 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $758.58 | Professional | None | $457.09 | $616.60 | $758.58 |
Midlands Setting Facility Modifier None Typical Low $398.11 Median $512.86 Typical High $954.99 | Facility | None | $398.11 | $512.86 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $660.69 | Professional | None | $398.11 | $575.44 | $660.69 |
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 $316.23 Median $501.19 Typical High $758.58 | Professional | None | $316.23 | $501.19 | $758.58 |
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 $93.33 Median $93.33 Typical High $134.90 | Professional | 52 · Reduced service | $93.33 | $93.33 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $54.95 | Professional | 53 · Discontinued | $38.02 | $38.02 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $204.17 | Professional | 54 · Surgery only | $141.25 | $141.25 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $40.74 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $131.83 | $131.83 | $190.55 |
Where Nebraska sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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· 21st of 51
$372
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.