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 $223.87 Median $1,548.82 Typical High $10,964.78 | Facility | None | $223.87 | $1,548.82 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $512.86 | Professional | None | $104.71 | $194.98 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $331.13 Typical High $338.84 | Professional | None | $158.49 | $331.13 | $338.84 |
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 $93.33 Median $165.96 Typical High $223.87 | Professional | None | $93.33 | $165.96 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $302.00 | Facility | None | $190.55 | $239.88 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $407.38 Typical High $501.19 | Professional | None | $245.47 | $407.38 | $501.19 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $1,071.52 Typical High $3,019.95 | Facility | None | $213.80 | $1,071.52 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $501.19 Typical High $1,584.89 | Professional | None | $275.42 | $501.19 | $1,584.89 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $575.44 | Professional | None | $251.19 | $426.58 | $575.44 |
Midlands Setting Facility Modifier None Typical Low $190.55 Median $251.19 Typical High $316.23 | Facility | None | $190.55 | $251.19 | $316.23 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $426.58 Typical High $575.44 | Professional | None | $218.78 | $426.58 | $575.44 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $3,162.28 | Facility | None | $707.95 | $1,445.44 | $3,162.28 |
United Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $501.19 | Professional | None | $158.49 | $275.42 | $501.19 |
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 $52.48 Median $93.33 Typical High $95.50 | Professional | 52 · Reduced service | $52.48 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $38.02 Typical High $38.90 | Professional | 53 · Discontinued | $20.89 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $141.25 Typical High $144.54 | Professional | 54 · Surgery only | $77.62 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $28.18 Typical High $28.84 | Professional | 55 · Aftercare only | $15.49 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $19.05 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.47 | $19.05 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $131.83 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $72.44 | $131.83 | $134.90 |
Where Nebraska sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 17th of 51
$224
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.