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 $501.19 Median $3,801.89 Typical High $11,481.54 | Facility | None | $501.19 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $630.96 | Professional | None | $331.13 | $501.19 | $630.96 |
BCBS Nebraska Setting Facility Modifier None Typical Low $6,309.57 Median $8,317.64 Typical High $16,982.44 | Facility | None | $6,309.57 | $8,317.64 | $16,982.44 |
BCBS Nebraska Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $724.44 | Professional | None | $295.12 | $524.81 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,584.89 Typical High $2,570.40 | Facility | None | $645.65 | $1,584.89 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,288.25 | Professional | None | $691.83 | $1,071.52 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $1,348.96 Typical High $7,943.28 | Facility | None | $630.96 | $1,348.96 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,318.26 Typical High $4,073.80 | Professional | None | $724.44 | $1,318.26 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,348.96 | Professional | None | $794.33 | $1,122.02 | $1,348.96 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $1,905.46 Typical High $2,754.23 | Facility | None | $645.65 | $1,905.46 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,445.44 | Professional | None | $691.83 | $1,096.48 | $1,445.44 |
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 $489.78 Median $831.76 Typical High $1,318.26 | Professional | None | $489.78 | $831.76 | $1,318.26 |
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 $165.96 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $165.96 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $66.07 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $74.13 Typical High $75.86 | Professional | 55 · Aftercare only | $50.12 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $33.11 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $346.74 | $346.74 |
Where Nebraska sits
The same service costs 3.7 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
$708
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.