How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,023 to $11,220Professionalmedian $1,023 · 10th to 90th $417 to $3,388
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 $912.01 Median $6,165.95 Typical High $12,589.25 | Facility | None | $912.01 | $6,165.95 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $1,096.48 | Professional | None | $416.87 | $549.54 | $1,096.48 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $338.84 | Professional | None | $288.40 | $288.40 | $338.84 |
BCBS Nebraska Setting Facility Modifier None Typical Low $6,606.93 Median $10,000.00 Typical High $20,892.96 | Facility | None | $6,606.93 | $10,000.00 | $20,892.96 |
BCBS Nebraska Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,623.41 | Professional | None | $5,128.61 | $5,128.61 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $6,606.93 | Facility | None | $2,511.89 | $3,630.78 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,288.25 | Professional | None | $776.25 | $1,096.48 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $8,912.51 | Facility | None | $831.76 | $1,819.70 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,096.48 Typical High $3,388.44 | Professional | None | $676.08 | $1,096.48 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,445.44 | Professional | None | $812.83 | $1,096.48 | $1,445.44 |
Midlands Setting Facility Modifier None Typical Low $2,290.87 Median $5,370.32 Typical High $8,912.51 | Facility | None | $2,290.87 | $5,370.32 | $8,912.51 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,445.44 | Professional | None | $812.83 | $1,000.00 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $7,585.78 | Facility | None | $1,174.90 | $1,862.09 | $7,585.78 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,023.29 Typical High $1,258.93 | Professional | None | $676.08 | $1,023.29 | $1,258.93 |
7 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 $208.93 Median $208.93 Typical High $239.88 | Professional | 52 · Reduced service | $208.93 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $95.50 | Professional | 53 · Discontinued | $83.18 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $354.81 | Professional | 54 · Surgery only | $316.23 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $70.79 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $47.86 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 59 · Distinct service | $933.25 | $933.25 | $933.25 |
Ambetter Setting Professional Modifier XS · Separate structure Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | XS · Separate structure | $144.54 | $144.54 | $144.54 |
Where Nebraska sits
The same service costs 6.1 times more in Alaska than in Montana. 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
AK $8,625MT $1,416
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.