How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,072 to $11,220Professionalmedian $1,047 · 10th to 90th $603 to $3,548
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 $954.99 Median $6,165.95 Typical High $12,589.25 | Facility | None | $954.99 | $6,165.95 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $1,174.90 | Professional | None | $436.52 | $436.52 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
BCBS Nebraska Setting Facility Modifier None Typical Low $7,762.47 Median $10,471.29 Typical High $20,892.96 | Facility | None | $7,762.47 | $10,471.29 | $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 $812.83 Median $1,148.15 Typical High $1,348.96 | Professional | None | $812.83 | $1,148.15 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $1,819.70 Typical High $7,943.28 | Facility | None | $851.14 | $1,819.70 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,148.15 Typical High $3,548.13 | Professional | None | $691.83 | $1,148.15 | $3,548.13 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,513.56 | Professional | None | $831.76 | $1,148.15 | $1,513.56 |
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 $831.76 Median $1,047.13 Typical High $1,513.56 | Professional | None | $831.76 | $1,047.13 | $1,513.56 |
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 $691.83 Median $1,047.13 Typical High $1,288.25 | Professional | None | $691.83 | $1,047.13 | $1,288.25 |
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 $218.78 Median $218.78 Typical High $245.47 | Professional | 52 · Reduced service | $218.78 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | 53 · Discontinued | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | 54 · Surgery only | $323.59 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $50.12 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $50.12 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 59 · Distinct service | $354.81 | $354.81 | $354.81 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | GC · Resident with teaching physician | $977.24 | $977.24 | $977.24 |
Where Nebraska sits
The same service costs 5.9 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 $8,723MT $1,483
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.