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 $134.90 Median $7,585.78 Typical High $12,589.25 | Facility | None | $134.90 | $7,585.78 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $173.78 | Professional | None | $93.33 | $134.90 | $173.78 |
BCBS Nebraska Setting Facility Modifier None Typical Low $5,623.41 Median $7,585.78 Typical High $15,488.17 | Facility | None | $5,623.41 | $7,585.78 | $15,488.17 |
BCBS Nebraska Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $181.97 | Professional | None | $79.43 | $138.04 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $141.25 Typical High $165.96 | Facility | None | $112.20 | $141.25 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $338.84 | Professional | None | $213.80 | $281.84 | $338.84 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $1,071.52 Typical High $3,019.95 | Facility | None | $169.82 | $1,071.52 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $281.84 Typical High $1,698.24 | Professional | None | $165.96 | $281.84 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $346.74 | Professional | None | $213.80 | $281.84 | $346.74 |
Midlands Setting Facility Modifier None Typical Low $117.49 Median $144.54 Typical High $173.78 | Facility | None | $117.49 | $144.54 | $173.78 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $309.03 | Professional | None | $190.55 | $269.15 | $309.03 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $3,311.31 | Facility | None | $707.95 | $1,445.44 | $3,311.31 |
United Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $316.23 | Professional | None | $131.83 | $218.78 | $316.23 |
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 $46.77 Median $46.77 Typical High $67.61 | Professional | 52 · Reduced service | $46.77 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $26.92 | Professional | 53 · Discontinued | $18.62 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $100.00 | Professional | 54 · Surgery only | $70.79 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $19.95 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $66.07 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $66.07 | $66.07 | $93.33 |
Where Nebraska sits
The same service costs 3.5 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· 21st of 51
$166
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.