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 $331.13 Median $4,466.84 Typical High $11,481.54 | Facility | None | $331.13 | $4,466.84 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $446.68 | Professional | None | $245.47 | $331.13 | $446.68 |
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 $218.78 Median $389.05 Typical High $537.03 | Professional | None | $218.78 | $389.05 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,584.89 Typical High $2,570.40 | Facility | None | $954.99 | $1,584.89 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $870.96 | Professional | None | $537.03 | $741.31 | $870.96 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $1,348.96 Typical High $7,943.28 | Facility | None | $588.84 | $1,348.96 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $954.99 Typical High $2,691.53 | Professional | None | $512.86 | $954.99 | $2,691.53 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $912.01 | Professional | None | $630.96 | $831.76 | $912.01 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,905.46 Typical High $2,754.23 | Facility | None | $954.99 | $1,905.46 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $1,000.00 | Professional | None | $537.03 | $794.33 | $1,000.00 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $4,073.80 | Facility | None | $707.95 | $1,445.44 | $4,073.80 |
United Setting Professional Modifier None Typical Low $389.05 Median $630.96 Typical High $912.01 | Professional | None | $389.05 | $630.96 | $912.01 |
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 $123.03 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $123.03 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $66.07 Typical High $74.13 | Professional | 53 · Discontinued | $48.98 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $251.19 Typical High $281.84 | Professional | 54 · Surgery only | $186.21 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $50.12 Typical High $56.23 | Professional | 55 · Aftercare only | $37.15 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $24.55 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $234.42 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $173.78 | $234.42 | $263.03 |
Where Nebraska sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 13th of 51
$513
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.