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 $288.40 Median $7,585.78 Typical High $12,589.25 | Facility | None | $288.40 | $7,585.78 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $323.59 | Professional | None | $169.82 | $251.19 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
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 $151.36 Median $269.15 Typical High $363.08 | Professional | None | $151.36 | $269.15 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $389.05 Typical High $512.86 | Facility | None | $234.42 | $389.05 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $602.56 Typical High $741.31 | Professional | None | $371.54 | $602.56 | $741.31 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $660.69 Typical High $2,290.87 | Facility | None | $323.59 | $660.69 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $741.31 Typical High $2,290.87 | Professional | None | $416.87 | $741.31 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $891.25 | Professional | None | $407.38 | $660.69 | $891.25 |
Midlands Setting Facility Modifier None Typical Low $234.42 Median $426.58 Typical High $549.54 | Facility | None | $234.42 | $426.58 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $354.81 Median $630.96 Typical High $891.25 | Professional | None | $354.81 | $630.96 | $891.25 |
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 $257.04 Median $436.52 Typical High $741.31 | Professional | None | $257.04 | $436.52 | $741.31 |
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 $85.11 Median $125.89 Typical High $144.54 | Professional | 52 · Reduced service | $85.11 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $50.12 Typical High $57.54 | Professional | 53 · Discontinued | $33.88 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $186.21 Typical High $213.80 | Professional | 54 · Surgery only | $128.82 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $37.15 Typical High $42.66 | Professional | 55 · Aftercare only | $25.70 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $25.12 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.98 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $173.78 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $120.23 | $173.78 | $199.53 |
Where Nebraska sits
The same service costs 4.5 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· 15th of 51
$347
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.