How much rates vary
Facilitymedian $1,660 · 10th to 90th $692 to $7,943Professionalmedian $447 · 10th to 90th $204 to $1,820
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 $446.68 Median $4,365.16 Typical High $11,481.54 | Facility | None | $446.68 | $4,365.16 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $645.65 Typical High $1,584.89 | Professional | None | $204.17 | $645.65 | $1,584.89 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
BCBS Nebraska Setting Facility Modifier None Typical Low $4,786.30 Median $6,309.57 Typical High $12,882.50 | Facility | None | $4,786.30 | $6,309.57 | $12,882.50 |
BCBS Nebraska Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $446.68 | Professional | None | $181.97 | $323.59 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,258.93 Typical High $2,137.96 | Facility | None | $954.99 | $1,258.93 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $1,348.96 Typical High $1,698.24 | Professional | None | $446.68 | $1,348.96 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $676.08 Median $1,348.96 Typical High $3,715.35 | Facility | None | $676.08 | $1,348.96 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,778.28 Typical High $5,370.32 | Professional | None | $1,000.00 | $1,778.28 | $5,370.32 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $1,584.89 Typical High $1,995.26 | Professional | None | $524.81 | $1,584.89 | $1,995.26 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,737.80 Typical High $2,884.03 | Facility | None | $954.99 | $1,737.80 | $2,884.03 |
Midlands Setting Professional Modifier None Typical Low $446.68 Median $1,412.54 Typical High $1,995.26 | Professional | None | $446.68 | $1,412.54 | $1,995.26 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $3,235.94 | Facility | None | $707.95 | $1,445.44 | $3,235.94 |
United Setting Professional Modifier None Typical Low $323.59 Median $912.01 Typical High $1,778.28 | Professional | None | $323.59 | $912.01 | $1,778.28 |
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 $102.33 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $102.33 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $40.74 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $151.36 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $30.90 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $20.42 | $64.57 | $64.57 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | GC · Resident with teaching physician | $457.09 | $457.09 | $457.09 |
Where Nebraska sits
The same service costs 3.4 times more in Colorado than in West Virginia. 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.
Physician feeFacility fee
CO $4,463WV $1,326
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.