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 $436.52 Median $7,943.28 Typical High $21,877.62 | Facility | None | $436.52 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $1,445.44 | Professional | None | $436.52 | $436.52 | $1,445.44 |
BCBS Nebraska Setting Facility Modifier None Typical Low $9,549.93 Median $12,882.50 Typical High $25,703.96 | Facility | None | $9,549.93 | $12,882.50 | $25,703.96 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,412.54 | Professional | None | $870.96 | $1,148.15 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,365.16 | Facility | None | $478.63 | $891.25 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $831.76 Median $1,445.44 Typical High $16,595.87 | Professional | None | $831.76 | $1,445.44 | $16,595.87 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $1,412.54 | Professional | None | $870.96 | $1,348.96 | $1,412.54 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,445.44 | Professional | None | $870.96 | $1,096.48 | $1,445.44 |
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 $831.76 Median $1,230.27 Typical High $1,548.82 | Professional | None | $831.76 | $1,230.27 | $1,548.82 |
4 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 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $467.74 | Professional | 54 · Surgery only | $331.13 | $331.13 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $93.33 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $61.66 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $436.52 |
Where Nebraska sits
The same service costs 11.7 times more in New York than in North Carolina. 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· 4th of 51
$1,230
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.