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 $112.20 Median $7,585.78 Typical High $12,589.25 | Facility | None | $112.20 | $7,585.78 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $295.12 | Professional | None | $85.11 | $112.20 | $295.12 |
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 $72.44 Median $123.03 Typical High $162.18 | Professional | None | $72.44 | $123.03 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $128.82 Typical High $144.54 | Facility | None | $102.33 | $128.82 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $281.84 | Professional | None | $194.98 | $239.88 | $281.84 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $223.87 Typical High $1,288.25 | Facility | None | $102.33 | $223.87 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $870.96 | Professional | None | $147.91 | $251.19 | $870.96 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $302.00 | Professional | None | $194.98 | $251.19 | $302.00 |
Midlands Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $151.36 | Facility | None | $104.71 | $128.82 | $151.36 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $263.03 | Professional | None | $169.82 | $229.09 | $263.03 |
United Setting Facility Modifier None Typical Low $104.71 Median $251.19 Typical High $1,230.27 | Facility | None | $104.71 | $251.19 | $1,230.27 |
United Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $275.42 | Professional | None | $120.23 | $199.53 | $275.42 |
7 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 $42.66 Median $42.66 Typical High $56.23 | Professional | 52 · Reduced service | $42.66 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $22.39 | Professional | 53 · Discontinued | $16.98 | $16.98 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $85.11 | Professional | 54 · Surgery only | $63.10 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $16.98 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $11.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $58.88 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $58.88 | $58.88 | $79.43 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 58 · Staged procedure | $263.03 | $263.03 | $263.03 |
Where Nebraska sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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· 17th of 51
$148
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.