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 $194.98 Median $3,801.89 Typical High $11,481.54 | Facility | None | $194.98 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $194.98 Typical High $478.63 | Professional | None | $102.33 | $194.98 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $194.98 Typical High $309.03 | Professional | None | $190.55 | $194.98 | $309.03 |
BCBS Nebraska Setting Facility Modifier None Typical Low $3,630.78 Median $4,786.30 Typical High $9,772.37 | Facility | None | $3,630.78 | $4,786.30 | $9,772.37 |
BCBS Nebraska Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $223.87 | Professional | None | $91.20 | $162.18 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $933.25 Typical High $1,174.90 | Facility | None | $645.65 | $933.25 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $416.87 Typical High $501.19 | Professional | None | $234.42 | $416.87 | $501.19 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $1,096.48 Typical High $3,715.35 | Facility | None | $389.05 | $1,096.48 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $549.54 Typical High $1,621.81 | Professional | None | $295.12 | $549.54 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $524.81 | Professional | None | $251.19 | $467.74 | $524.81 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $977.24 Typical High $1,230.27 | Facility | None | $645.65 | $977.24 | $1,230.27 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $416.87 Typical High $602.56 | Professional | None | $213.80 | $416.87 | $602.56 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $3,162.28 | Facility | None | $707.95 | $1,445.44 | $3,162.28 |
United Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $524.81 | Professional | None | $151.36 | $281.84 | $524.81 |
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 $50.12 Median $93.33 Typical High $97.72 | Professional | 52 · Reduced service | $50.12 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $37.15 Typical High $38.90 | Professional | 53 · Discontinued | $20.42 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $138.04 Typical High $144.54 | Professional | 54 · Surgery only | $75.86 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $27.54 Typical High $28.84 | Professional | 55 · Aftercare only | $15.14 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $18.62 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.00 | $18.62 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $128.82 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $70.79 | $128.82 | $134.90 |
Where Nebraska sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 18th of 51
$224
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.