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 $208.93 Median $7,943.28 Typical High $21,877.62 | Facility | None | $208.93 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $389.05 | Professional | None | $208.93 | $208.93 | $389.05 |
BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,882.50 Typical High $26,302.68 | Facility | None | $9,772.37 | $12,882.50 | $26,302.68 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $691.83 | Professional | None | $407.38 | $549.54 | $691.83 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $794.33 Typical High $3,715.35 | Facility | None | $398.11 | $794.33 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $4,365.16 | Professional | None | $338.84 | $549.54 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $724.44 | Professional | None | $407.38 | $549.54 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $724.44 | Professional | None | $407.38 | $512.86 | $724.44 |
United Setting Facility Modifier None Typical Low $489.78 Median $891.25 Typical High $3,801.89 | Facility | None | $489.78 | $891.25 | $3,801.89 |
United Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $630.96 | Professional | None | $338.84 | $478.63 | $630.96 |
5 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 $104.71 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $104.71 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $51.29 | Professional | 53 · Discontinued | $41.69 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 54 · Surgery only | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $38.02 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $25.70 |
Where Nebraska sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$537
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.