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 $134.90 Median $3,801.89 Typical High $11,481.54 | Facility | None | $134.90 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $194.98 | Professional | None | $102.33 | $134.90 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
BCBS 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 Setting Professional Modifier None Typical Low $91.20 Median $158.49 Typical High $204.17 | Professional | None | $91.20 | $158.49 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $173.78 Typical High $204.17 | Facility | None | $138.04 | $173.78 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $346.74 | Professional | None | $223.87 | $323.59 | $346.74 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $1,071.52 Typical High $3,715.35 | Facility | None | $194.98 | $1,071.52 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $1,096.48 | Professional | None | $208.93 | $389.05 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $371.54 | Professional | None | $251.19 | $338.84 | $371.54 |
Midlands Setting Facility Modifier None Typical Low $138.04 Median $173.78 Typical High $223.87 | Facility | None | $138.04 | $173.78 | $223.87 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $380.19 | Professional | None | $213.80 | $323.59 | $380.19 |
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 $257.04 Typical High $371.54 | Professional | None | $151.36 | $257.04 | $371.54 |
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 $51.29 Median $67.61 Typical High $75.86 | Professional | 52 · Reduced service | $51.29 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.92 Typical High $30.20 | Professional | 53 · Discontinued | $20.42 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $100.00 Typical High $112.20 | Professional | 54 · Surgery only | $77.62 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.95 Typical High $22.39 | Professional | 55 · Aftercare only | $15.49 | $19.95 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.49 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.23 | $13.49 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $93.33 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $72.44 | $93.33 | $104.71 |
Where Nebraska sits
The same service costs 4.0 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
$204
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.