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 $70.79 Median $3,801.89 Typical High $11,481.54 | Facility | None | $70.79 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $70.79 Typical High $186.21 | Professional | None | $27.54 | $70.79 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $154.88 | Professional | None | $89.13 | $125.89 | $154.88 |
BCBS Nebraska Setting Facility Modifier None Typical Low $363.08 Median $489.78 Typical High $977.24 | Facility | None | $363.08 | $489.78 | $977.24 |
BCBS Nebraska Setting Professional Modifier None Typical Low $23.99 Median $42.66 Typical High $58.88 | Professional | None | $23.99 | $42.66 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $93.33 Typical High $104.71 | Facility | None | $77.62 | $93.33 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $147.91 Typical High $181.97 | Professional | None | $66.07 | $147.91 | $181.97 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $213.80 Typical High $1,230.27 | Facility | None | $70.79 | $213.80 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $660.69 | Professional | None | $95.50 | $169.82 | $660.69 |
Midlands Setting Professional Modifier None Typical Low $66.07 Median $154.88 Typical High $194.98 | Professional | None | $66.07 | $154.88 | $194.98 |
Midlands Setting Facility Modifier None Typical Low $77.62 Median $93.33 Typical High $109.65 | Facility | None | $77.62 | $93.33 | $109.65 |
Midlands Setting Professional Modifier None Typical Low $57.54 Median $144.54 Typical High $165.96 | Professional | None | $57.54 | $144.54 | $165.96 |
United Setting Facility Modifier None Typical Low $104.71 Median $251.19 Typical High $1,230.27 | Facility | None | $104.71 | $251.19 | $1,230.27 |
United Setting Professional Modifier None Typical Low $44.67 Median $97.72 Typical High $181.97 | Professional | None | $44.67 | $97.72 | $181.97 |
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 $13.80 Median $13.80 Typical High $35.48 | Professional | 52 · Reduced service | $13.80 | $13.80 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $14.13 | Professional | 53 · Discontinued | $5.50 | $5.50 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $20.89 Typical High $52.48 | Professional | 54 · Surgery only | $20.89 | $20.89 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $10.47 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $7.08 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $7.08 |
Where Nebraska sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 51st of 51
$60.26
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.