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 $269.15 Median $4,466.84 Typical High $11,481.54 | Facility | None | $269.15 | $4,466.84 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $1,445.44 | Professional | None | $186.21 | $269.15 | $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 $371.54 | Professional | None | $162.18 | $288.40 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $338.84 Typical High $446.68 | Facility | None | $288.40 | $338.84 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $707.95 | Professional | None | $446.68 | $588.84 | $707.95 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $269.15 Typical High $1,778.28 | Facility | None | $102.33 | $269.15 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $2,137.96 | Professional | None | $426.58 | $691.83 | $2,137.96 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $724.44 | Professional | None | $457.09 | $616.60 | $724.44 |
Midlands Setting Facility Modifier None Typical Low $288.40 Median $338.84 Typical High $457.09 | Facility | None | $288.40 | $338.84 | $457.09 |
Midlands Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $645.65 | Professional | None | $389.05 | $562.34 | $645.65 |
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 $323.59 Median $512.86 Typical High $831.76 | Professional | None | $323.59 | $512.86 | $831.76 |
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 $131.83 | Professional | 52 · Reduced service | $93.33 | $93.33 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $53.70 | Professional | 53 · Discontinued | $37.15 | $37.15 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $199.53 | Professional | 54 · Surgery only | $141.25 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $39.81 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $131.83 | $131.83 | $186.21 |
Where Nebraska sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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· 27th of 51
$347
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.