How much rates vary
Facilitymedian $631 · 10th to 90th $331 to $6,026Professionalmedian $355 · 10th to 90th $178 to $692
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 $389.05 Median $1,548.82 Typical High $10,964.78 | Facility | None | $389.05 | $1,548.82 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $645.65 | Professional | None | $177.83 | $263.03 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $630.96 | Professional | None | $107.15 | $141.25 | $630.96 |
BCBS Nebraska Setting Facility Modifier None Typical Low $4,168.69 Median $5,495.41 Typical High $11,220.18 | Facility | None | $4,168.69 | $5,495.41 | $11,220.18 |
BCBS Nebraska Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $354.81 | Professional | None | $162.18 | $275.42 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $346.74 Typical High $416.87 | Facility | None | $275.42 | $346.74 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $691.83 | Professional | None | $389.05 | $602.56 | $691.83 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $707.95 Typical High $3,235.94 | Facility | None | $398.11 | $707.95 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $676.08 Typical High $2,089.30 | Professional | None | $389.05 | $676.08 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $794.33 | Professional | None | $436.52 | $616.60 | $794.33 |
Midlands Setting Facility Modifier None Typical Low $275.42 Median $354.81 Typical High $436.52 | Facility | None | $275.42 | $354.81 | $436.52 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $602.56 Typical High $812.83 | Professional | None | $371.54 | $602.56 | $812.83 |
Oscar Health Setting Facility Modifier None Typical Low $269.15 Median $478.63 Typical High $1,023.29 | Facility | None | $269.15 | $478.63 | $1,023.29 |
United Setting Facility Modifier None Typical Low $467.74 Median $851.14 Typical High $2,754.23 | Facility | None | $467.74 | $851.14 | $2,754.23 |
United Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $676.08 | Professional | None | $275.42 | $457.09 | $676.08 |
8 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 $89.13 Median $131.83 Typical High $138.04 | Professional | 52 · Reduced service | $89.13 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $52.48 Typical High $54.95 | Professional | 53 · Discontinued | $35.48 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $194.98 Typical High $208.93 | Professional | 54 · Surgery only | $134.90 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $39.81 Typical High $41.69 | Professional | 55 · Aftercare only | $26.92 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $26.30 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.78 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $181.97 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $125.89 | $181.97 | $194.98 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 59 · Distinct service | $281.84 | $281.84 | $281.84 |
Ambetter Setting Professional Modifier XS · Separate structure Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | XS · Separate structure | $457.09 | $457.09 | $457.09 |
Where Nebraska sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 13th of 51
$363
AK $776KY $204
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.