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 $213.80 Median $3,801.89 Typical High $11,481.54 | Facility | None | $213.80 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $562.34 | Professional | None | $154.88 | $213.80 | $562.34 |
BCBS Nebraska Setting Facility Modifier None Typical Low $6,606.93 Median $8,912.51 Typical High $17,782.79 | Facility | None | $6,606.93 | $8,912.51 | $17,782.79 |
BCBS Nebraska Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $309.03 | Professional | None | $138.04 | $234.42 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $263.03 Typical High $295.12 | Facility | None | $218.78 | $263.03 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $562.34 | Professional | None | $338.84 | $467.74 | $562.34 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $1,096.48 Typical High $3,715.35 | Facility | None | $295.12 | $1,096.48 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $616.60 Typical High $1,737.80 | Professional | None | $323.59 | $616.60 | $1,737.80 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $588.84 | Professional | None | $380.19 | $524.81 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $218.78 Median $257.04 Typical High $323.59 | Facility | None | $218.78 | $257.04 | $323.59 |
Midlands Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $645.65 | Professional | None | $323.59 | $512.86 | $645.65 |
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 $229.09 Median $389.05 Typical High $575.44 | Professional | None | $229.09 | $389.05 | $575.44 |
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 $77.62 Median $107.15 Typical High $120.23 | Professional | 52 · Reduced service | $77.62 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $42.66 Typical High $47.86 | Professional | 53 · Discontinued | $30.90 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $162.18 Typical High $181.97 | Professional | 54 · Surgery only | $114.82 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $22.91 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $21.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.49 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $151.36 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $107.15 | $151.36 | $169.82 |
Where Nebraska sits
The same service costs 3.8 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· 14th of 51
$316
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.