How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,514 to $12,589Professionalmedian $1,259 · 10th to 90th $589 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 $1,096.48 Median $7,585.78 Typical High $15,848.93 | Facility | None | $1,096.48 | $7,585.78 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $1,318.26 | Professional | None | $501.19 | $602.56 | $1,318.26 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $758.58 Typical High $758.58 | Professional | None | $102.33 | $758.58 | $758.58 |
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 $4,168.69 Median $4,168.69 Typical High $4,570.88 | Professional | None | $4,168.69 | $4,168.69 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $4,073.80 Typical High $5,248.07 | Facility | None | $1,949.84 | $4,073.80 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,584.89 | Professional | None | $912.01 | $1,258.93 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $1,445.44 Median $3,801.89 Typical High $16,218.10 | Facility | None | $1,445.44 | $3,801.89 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,288.25 Typical High $4,570.88 | Professional | None | $776.25 | $1,288.25 | $4,570.88 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,258.93 | $1,659.59 |
Midlands Setting Facility Modifier None Typical Low $1,949.84 Median $4,073.80 Typical High $5,623.41 | Facility | None | $1,949.84 | $4,073.80 | $5,623.41 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,318.26 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $8,317.64 | Facility | None | $1,698.24 | $3,801.89 | $8,317.64 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,445.44 | Professional | None | $776.25 | $1,148.15 | $1,445.44 |
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 $251.19 Median $251.19 Typical High $302.00 | Professional | 52 · Reduced service | $251.19 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $102.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $380.19 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $60.26 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $416.87 |
Where Nebraska sits
The same service costs 6.0 times more in Wisconsin 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
WI $11,096MT $1,846
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.