How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,380 to $11,482Professionalmedian $1,349 · 10th to 90th $794 to $4,365
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 $537.03 Median $537.03 Typical High $1,584.89 | Professional | None | $537.03 | $537.03 | $1,584.89 |
BCBS Nebraska Setting Facility Modifier None Typical Low $7,943.28 Median $10,715.19 Typical High $21,379.62 | Facility | None | $7,943.28 | $10,715.19 | $21,379.62 |
BCBS Nebraska Setting Professional Modifier None Typical Low $2,454.71 Median $2,511.89 Typical High $2,754.23 | Professional | None | $2,454.71 | $2,511.89 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $2,570.40 Typical High $3,162.28 | Facility | None | $1,380.38 | $2,570.40 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $1,698.24 | Professional | None | $977.24 | $1,348.96 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $9,549.93 | Facility | None | $1,122.02 | $2,137.96 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $4,365.16 | Professional | None | $831.76 | $1,380.38 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,348.96 | $1,778.28 |
Midlands Setting Facility Modifier None Typical Low $1,380.38 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,380.38 | $2,630.27 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,380.38 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,238.72 Typical High $6,309.57 | Facility | None | $1,288.25 | $2,238.72 | $6,309.57 |
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 |
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 $269.15 Median $269.15 Typical High $323.59 | Professional | 52 · Reduced service | $269.15 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $128.82 | Professional | 53 · Discontinued | $107.15 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $478.63 | Professional | 54 · Surgery only | $407.38 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $446.68 |
Where Nebraska sits
The same service costs 4.0 times more in Oklahoma 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
OK $7,787MT $1,955
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.