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 $7,585.78 Typical High $12,589.25 | Facility | None | $181.97 | $7,585.78 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $181.97 | Professional | None | $109.65 | $181.97 | $181.97 |
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 $95.50 Median $165.96 Typical High $223.87 | Professional | None | $95.50 | $165.96 | $223.87 |
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 $257.04 Median $380.19 Typical High $467.74 | Professional | None | $257.04 | $380.19 | $467.74 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $1,071.52 Typical High $3,019.95 | Facility | None | $199.53 | $1,071.52 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $1,412.54 | Professional | None | $275.42 | $457.09 | $1,412.54 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $512.86 | Professional | None | $269.15 | $416.87 | $512.86 |
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 $229.09 Median $380.19 Typical High $436.52 | Professional | None | $229.09 | $380.19 | $436.52 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,348.96 Typical High $3,162.28 | Facility | None | $707.95 | $1,348.96 | $3,162.28 |
United Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $489.78 | Professional | None | $177.83 | $295.12 | $489.78 |
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 $54.95 Median $54.95 Typical High $91.20 | Professional | 52 · Reduced service | $54.95 | $54.95 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $36.31 | Professional | 53 · Discontinued | $21.88 | $21.88 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $134.90 | Professional | 54 · Surgery only | $83.18 | $83.18 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $26.92 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $77.62 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $77.62 | $77.62 | $125.89 |
Where Nebraska sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 30th 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.