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 $38.90 Median $70.79 Typical High $1,071.52 | Professional | None | $38.90 | $70.79 | $1,071.52 |
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 $33.88 Median $60.26 Typical High $77.62 | Professional | None | $33.88 | $60.26 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $81.28 Typical High $95.50 | Facility | None | $64.57 | $81.28 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $181.97 | Professional | None | $91.20 | $147.91 | $181.97 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $213.80 Typical High $1,995.26 | Facility | None | $72.44 | $213.80 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $1,380.38 | Professional | None | $93.33 | $158.49 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $194.98 | Professional | None | $93.33 | $158.49 | $194.98 |
Midlands Setting Facility Modifier None Typical Low $66.07 Median $85.11 Typical High $97.72 | Facility | None | $66.07 | $85.11 | $97.72 |
Midlands Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $165.96 | Professional | None | $79.43 | $144.54 | $165.96 |
United Setting Facility Modifier None Typical Low $104.71 Median $218.78 Typical High $1,230.27 | Facility | None | $104.71 | $218.78 | $1,230.27 |
United Setting Professional Modifier None Typical Low $58.88 Median $100.00 Typical High $177.83 | Professional | None | $58.88 | $100.00 | $177.83 |
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 $19.50 Median $19.50 Typical High $35.48 | Professional | 52 · Reduced service | $19.50 | $19.50 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $14.13 | Professional | 53 · Discontinued | $7.76 | $7.76 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $28.84 Typical High $52.48 | Professional | 54 · Surgery only | $28.84 | $28.84 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $10.47 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $7.08 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $7.08 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 79 · Unrelated procedure after surgery | $151.36 | $151.36 | $151.36 |
Where Nebraska sits
The same service costs 3.2 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· 37th of 51
$75.86
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.