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 $426.58 Median $7,585.78 Typical High $12,589.25 | Facility | None | $426.58 | $7,585.78 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $489.78 | Professional | None | $281.84 | $426.58 | $489.78 |
BCBS Nebraska Setting Facility Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $6,025.60 | Facility | None | $2,187.76 | $2,951.21 | $6,025.60 |
BCBS Nebraska Setting Professional Modifier None Typical Low $251.19 Median $446.68 Typical High $575.44 | Professional | None | $251.19 | $446.68 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $691.83 | Facility | None | $416.87 | $537.03 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $891.25 Typical High $1,122.02 | Professional | None | $549.54 | $891.25 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $2,137.96 Typical High $5,370.32 | Facility | None | $524.81 | $2,137.96 | $5,370.32 |
Medica Setting Professional Modifier None Typical Low $630.96 Median $1,096.48 Typical High $3,467.37 | Professional | None | $630.96 | $1,096.48 | $3,467.37 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $1,258.93 | Professional | None | $616.60 | $891.25 | $1,258.93 |
Midlands Setting Facility Modifier None Typical Low $416.87 Median $602.56 Typical High $741.31 | Facility | None | $416.87 | $602.56 | $741.31 |
Midlands Setting Professional Modifier None Typical Low $588.84 Median $954.99 Typical High $1,258.93 | Professional | None | $588.84 | $954.99 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $3,019.95 Typical High $6,606.93 | Facility | None | $1,380.38 | $3,019.95 | $6,606.93 |
United Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $1,096.48 | Professional | None | $416.87 | $691.83 | $1,096.48 |
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 $141.25 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $141.25 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $56.23 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $213.80 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $42.66 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $42.66 Typical High $43.65 | Professional | 56 · Pre-op care only | $28.18 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $199.53 | $302.00 | $302.00 |
Where Nebraska sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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
$562
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.