How much rates vary
Facilitymedian $1,380 · 10th to 90th $324 to $6,761Professionalmedian $151 · 10th to 90th $71 to $661
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 $245.47 Median $3,801.89 Typical High $11,481.54 | Facility | None | $245.47 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $245.47 Typical High $645.65 | Professional | None | $69.18 | $245.47 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
BCBS Nebraska Setting Facility Modifier None Typical Low $2,691.53 Median $3,630.78 Typical High $7,413.10 | Facility | None | $2,691.53 | $3,630.78 | $7,413.10 |
BCBS Nebraska Setting Professional Modifier None Typical Low $61.66 Median $109.65 Typical High $151.36 | Professional | None | $61.66 | $109.65 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $371.54 Typical High $457.09 | Facility | None | $295.12 | $371.54 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $524.81 Typical High $645.65 | Professional | None | $165.96 | $524.81 | $645.65 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $1,096.48 Typical High $3,019.95 | Facility | None | $457.09 | $1,096.48 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $660.69 Typical High $2,041.74 | Professional | None | $363.08 | $660.69 | $2,041.74 |
Midlands Setting Professional Modifier None Typical Low $173.78 Median $549.54 Typical High $758.58 | Professional | None | $173.78 | $549.54 | $758.58 |
Midlands Setting Facility Modifier None Typical Low $295.12 Median $398.11 Typical High $489.78 | Facility | None | $295.12 | $398.11 | $489.78 |
Midlands Setting Professional Modifier None Typical Low $144.54 Median $549.54 Typical High $758.58 | Professional | None | $144.54 | $549.54 | $758.58 |
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 $107.15 Median $288.40 Typical High $630.96 | Professional | None | $107.15 | $288.40 | $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 $34.67 Median $95.50 Typical High $123.03 | Professional | 52 · Reduced service | $34.67 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $38.90 Typical High $50.12 | Professional | 53 · Discontinued | $13.80 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $144.54 Typical High $186.21 | Professional | 54 · Surgery only | $51.29 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $28.84 Typical High $37.15 | Professional | 55 · Aftercare only | $10.23 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $19.50 Typical High $24.55 | Professional | 56 · Pre-op care only | $6.92 | $19.50 | $24.55 |
Where Nebraska sits
The same service costs 9.0 times more in Colorado 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
CO $4,579MT $507
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.