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 $4,677.35 Median $7,943.28 Typical High $21,877.62 | Facility | None | $4,677.35 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,318.26 | $2,398.83 |
BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $8,128.31 Typical High $16,595.87 | Facility | None | $6,165.95 | $8,128.31 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $3,311.31 Typical High $4,073.80 | Professional | None | $2,344.23 | $3,311.31 | $4,073.80 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $977.24 Typical High $4,365.16 | Facility | None | $478.63 | $977.24 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $2,041.74 Median $3,388.44 Typical High $10,715.19 | Professional | None | $2,041.74 | $3,388.44 | $10,715.19 |
Midlands Setting Professional Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $4,365.16 | Professional | None | $2,630.27 | $3,311.31 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $4,365.16 | Professional | None | $2,630.27 | $3,235.94 | $4,365.16 |
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 $2,041.74 Median $2,951.21 Typical High $3,801.89 | Professional | None | $2,041.74 | $2,951.21 | $3,801.89 |
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 $645.65 Median $645.65 Typical High $776.25 | Professional | 52 · Reduced service | $645.65 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | 53 · Discontinued | $263.03 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $154.88 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,096.48 |
Where Nebraska sits
The same service costs 5.2 times more in Alaska than in Texas. 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· 3rd of 51
$3,236
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.