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 $7,943.28 Typical High $21,877.62 | Facility | None | $501.19 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $933.25 | Professional | None | $501.19 | $501.19 | $933.25 |
BCBS Nebraska Setting Facility Modifier None Typical Low $3,630.78 Median $4,786.30 Typical High $9,772.37 | Facility | None | $3,630.78 | $4,786.30 | $9,772.37 |
BCBS Nebraska Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $870.96 | Professional | None | $724.44 | $776.25 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,230.27 | Facility | None | $1,000.00 | $1,148.15 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Professional | None | $933.25 | $1,258.93 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $1,122.02 Typical High $4,570.88 | Facility | None | $691.83 | $1,122.02 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,288.25 Typical High $4,168.69 | Professional | None | $776.25 | $1,288.25 | $4,168.69 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,258.93 | $1,659.59 |
Midlands Setting Facility Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,698.24 | Facility | None | $1,000.00 | $1,148.15 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,318.26 | $1,659.59 |
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 $776.25 Median $1,071.52 Typical High $1,412.54 | Professional | None | $776.25 | $1,071.52 | $1,412.54 |
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 $251.19 Median $251.19 Typical High $302.00 | Professional | 52 · Reduced service | $251.19 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $102.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $380.19 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $60.26 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $416.87 |
Where Nebraska sits
The same service costs 5.5 times more in Alaska than in Texas. 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· 3rd of 51
$1,230
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.