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 $194.98 Median $3,801.89 Typical High $11,481.54 | Facility | None | $194.98 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $263.03 | Professional | None | $144.54 | $194.98 | $263.03 |
BCBS Nebraska Setting Facility Modifier None Typical Low $6,025.60 Median $8,128.31 Typical High $16,218.10 | Facility | None | $6,025.60 | $8,128.31 | $16,218.10 |
BCBS Nebraska Setting Professional Modifier None Typical Low $128.82 Median $234.42 Typical High $316.23 | Professional | None | $128.82 | $234.42 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $977.24 Typical High $1,174.90 | Facility | None | $645.65 | $977.24 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $512.86 | Professional | None | $316.23 | $426.58 | $512.86 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $1,122.02 Typical High $3,715.35 | Facility | None | $380.19 | $1,122.02 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $562.34 Typical High $1,621.81 | Professional | None | $302.00 | $562.34 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $537.03 | Professional | None | $346.74 | $478.63 | $537.03 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,412.54 | Facility | None | $645.65 | $1,000.00 | $1,412.54 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $602.56 | Professional | None | $302.00 | $467.74 | $602.56 |
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 $213.80 Median $363.08 Typical High $524.81 | Professional | None | $213.80 | $363.08 | $524.81 |
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 $72.44 Median $97.72 Typical High $109.65 | Professional | 52 · Reduced service | $72.44 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $38.90 Typical High $43.65 | Professional | 53 · Discontinued | $28.84 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $147.91 Typical High $162.18 | Professional | 54 · Surgery only | $109.65 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $29.51 Typical High $32.36 | Professional | 55 · Aftercare only | $21.88 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $19.50 Typical High $21.88 | Professional | 56 · Pre-op care only | $14.45 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $138.04 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $102.33 | $138.04 | $151.36 |
Where Nebraska sits
The same service costs 4.2 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
$302
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.