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 $125.89 Median $3,801.89 Typical High $11,481.54 | Facility | None | $125.89 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $1,071.52 | Professional | None | $74.13 | $125.89 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
BCBS Nebraska Setting Facility Modifier None Typical Low $2,290.87 Median $3,019.95 Typical High $6,165.95 | Facility | None | $2,290.87 | $3,019.95 | $6,165.95 |
BCBS Nebraska Setting Professional Modifier None Typical Low $64.57 Median $114.82 Typical High $158.49 | Professional | None | $64.57 | $114.82 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $691.83 | Facility | None | $426.58 | $549.54 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $323.59 | Professional | None | $177.83 | $263.03 | $323.59 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $660.69 Typical High $2,290.87 | Facility | None | $239.88 | $660.69 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $1,819.70 | Professional | None | $173.78 | $295.12 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $346.74 | Professional | None | $177.83 | $281.84 | $346.74 |
Midlands Setting Facility Modifier None Typical Low $436.52 Median $549.54 Typical High $691.83 | Facility | None | $436.52 | $549.54 | $691.83 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $302.00 | Professional | None | $154.88 | $257.04 | $302.00 |
United Setting Facility Modifier None Typical Low $467.74 Median $851.14 Typical High $2,754.23 | Facility | None | $467.74 | $851.14 | $2,754.23 |
United Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $323.59 | Professional | None | $114.82 | $190.55 | $323.59 |
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 $37.15 Median $37.15 Typical High $63.10 | Professional | 52 · Reduced service | $37.15 | $37.15 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $25.12 | Professional | 53 · Discontinued | $14.79 | $14.79 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $93.33 | Professional | 54 · Surgery only | $56.23 | $56.23 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $19.05 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $12.59 |
Where Nebraska sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 33rd of 51
$155
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.