How much rates vary
Facilitymedian $2,089 · 10th to 90th $794 to $7,943Professionalmedian $302 · 10th to 90th $155 to $759
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 $281.84 Median $4,466.84 Typical High $11,481.54 | Facility | None | $281.84 | $4,466.84 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $346.74 | Professional | None | $151.36 | $281.84 | $346.74 |
BCBS Nebraska Setting Facility Modifier None Typical Low $5,248.07 Median $6,918.31 Typical High $14,125.38 | Facility | None | $5,248.07 | $6,918.31 | $14,125.38 |
BCBS Nebraska Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $331.13 | Professional | None | $134.90 | $239.88 | $331.13 |
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 $331.13 Median $588.84 Typical High $741.31 | Professional | None | $331.13 | $588.84 | $741.31 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $1,174.90 Typical High $7,943.28 | Facility | None | $549.54 | $1,174.90 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $741.31 Typical High $2,290.87 | Professional | None | $398.11 | $741.31 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $354.81 Median $616.60 Typical High $758.58 | Professional | None | $354.81 | $616.60 | $758.58 |
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 $316.23 Median $602.56 Typical High $776.25 | Professional | None | $316.23 | $602.56 | $776.25 |
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 $218.78 Median $398.11 Typical High $707.95 | Professional | None | $218.78 | $398.11 | $707.95 |
7 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 $75.86 Median $134.90 Typical High $141.25 | Professional | 52 · Reduced service | $75.86 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $54.95 Typical High $56.23 | Professional | 53 · Discontinued | $30.20 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $204.17 Typical High $208.93 | Professional | 54 · Surgery only | $114.82 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $40.74 Typical High $41.69 | Professional | 55 · Aftercare only | $22.91 | $40.74 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $27.54 Typical High $28.18 | Professional | 56 · Pre-op care only | $15.14 | $27.54 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $190.55 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $107.15 | $190.55 | $194.98 |
Ambetter Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $43.65 | $43.65 | $43.65 |
Where Nebraska sits
The same service costs 7.2 times more in Colorado than in North Dakota. 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.
Physician feeFacility fee
CO $4,681ND $651
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.