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 $162.18 Median $3,801.89 Typical High $11,481.54 | Facility | None | $162.18 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $213.80 | Professional | None | $102.33 | $162.18 | $213.80 |
BCBS Nebraska Setting Facility Modifier None Typical Low $3,311.31 Median $4,466.84 Typical High $8,912.51 | Facility | None | $3,311.31 | $4,466.84 | $8,912.51 |
BCBS Nebraska Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $204.17 | Professional | None | $91.20 | $162.18 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $208.93 Typical High $229.09 | Facility | None | $169.82 | $208.93 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $426.58 | Professional | None | $223.87 | $346.74 | $426.58 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $239.88 Typical High $1,288.25 | Facility | None | $102.33 | $239.88 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $1,318.26 | Professional | None | $251.19 | $457.09 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $457.09 | Professional | None | $257.04 | $398.11 | $457.09 |
Midlands Setting Facility Modifier None Typical Low $169.82 Median $208.93 Typical High $234.42 | Facility | None | $169.82 | $208.93 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $489.78 | Professional | None | $213.80 | $354.81 | $489.78 |
United Setting Facility Modifier None Typical Low $104.71 Median $251.19 Typical High $1,230.27 | Facility | None | $104.71 | $251.19 | $1,230.27 |
United Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $446.68 | Professional | None | $158.49 | $263.03 | $446.68 |
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 $81.28 Typical High $85.11 | Professional | 52 · Reduced service | $50.12 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $32.36 Typical High $33.88 | Professional | 53 · Discontinued | $20.42 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $123.03 Typical High $128.82 | Professional | 54 · Surgery only | $75.86 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $24.55 Typical High $25.70 | Professional | 55 · Aftercare only | $15.14 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $16.22 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.23 | $16.22 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $114.82 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $70.79 | $114.82 | $120.23 |
Where Nebraska sits
The same service costs 3.5 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· 18th 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.