How much rates vary
Facilitymedian $1,549 · 10th to 90th $389 to $7,943Professionalmedian $229 · 10th to 90th $117 to $447
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 $269.15 Median $1,548.82 Typical High $10,964.78 | Facility | None | $269.15 | $1,548.82 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $1,071.52 | Professional | None | $128.82 | $186.21 | $1,071.52 |
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 $107.15 Median $190.55 Typical High $263.03 | Professional | None | $107.15 | $190.55 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,479.11 Typical High $1,995.26 | Facility | None | $645.65 | $1,479.11 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $467.74 | Professional | None | $295.12 | $398.11 | $467.74 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $1,122.02 Typical High $5,623.41 | Facility | None | $346.74 | $1,122.02 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $426.58 Typical High $1,659.59 | Professional | None | $245.47 | $426.58 | $1,659.59 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $501.19 | Professional | None | $302.00 | $407.38 | $501.19 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $1,513.56 Typical High $2,089.30 | Facility | None | $645.65 | $1,513.56 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $436.52 | Professional | None | $257.04 | $380.19 | $436.52 |
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 $186.21 Median $309.03 Typical High $467.74 | Professional | None | $186.21 | $309.03 | $467.74 |
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 $64.57 Median $64.57 Typical High $93.33 | Professional | 52 · Reduced service | $64.57 | $64.57 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $38.02 | Professional | 53 · Discontinued | $25.70 | $25.70 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $141.25 | Professional | 54 · Surgery only | $95.50 | $95.50 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $28.18 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $89.13 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $89.13 | $89.13 | $131.83 |
Where Nebraska sits
The same service costs 9.9 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,605MT $466
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.