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 $331.13 Median $4,466.84 Typical High $11,481.54 | Facility | None | $331.13 | $4,466.84 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $331.13 Typical High $1,445.44 | Professional | None | $151.36 | $331.13 | $1,445.44 |
BCBS Nebraska Setting Facility Modifier None Typical Low $5,248.07 Median $7,079.46 Typical High $14,454.40 | Facility | None | $5,248.07 | $7,079.46 | $14,454.40 |
BCBS Nebraska Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $323.59 | Professional | None | $134.90 | $234.42 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $562.34 Typical High $954.99 | Facility | None | $436.52 | $562.34 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $724.44 Typical High $891.25 | Professional | None | $363.08 | $724.44 | $891.25 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $741.31 Typical High $2,290.87 | Facility | None | $398.11 | $741.31 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $891.25 Typical High $2,818.38 | Professional | None | $501.19 | $891.25 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $724.44 Typical High $912.01 | Professional | None | $371.54 | $724.44 | $912.01 |
Midlands Setting Facility Modifier None Typical Low $446.68 Median $562.34 Typical High $954.99 | Facility | None | $446.68 | $562.34 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $691.83 Typical High $794.33 | Professional | None | $316.23 | $691.83 | $794.33 |
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 $239.88 Median $501.19 Typical High $977.24 | Professional | None | $239.88 | $501.19 | $977.24 |
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 $75.86 Median $75.86 Typical High $165.96 | Professional | 52 · Reduced service | $75.86 | $75.86 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $67.61 | Professional | 53 · Discontinued | $30.90 | $30.90 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $251.19 | Professional | 54 · Surgery only | $114.82 | $114.82 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $50.12 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $33.11 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $33.11 |
Where Nebraska sits
The same service costs 2.8 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· 50th of 51
$324
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.