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 $95.50 Median $3,801.89 Typical High $11,481.54 | Facility | None | $95.50 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $251.19 | Professional | None | $60.26 | $95.50 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
BCBS Nebraska Setting Facility Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $4,365.16 | Facility | None | $1,621.81 | $2,187.76 | $4,365.16 |
BCBS Nebraska Setting Professional Modifier None Typical Low $52.48 Median $91.20 Typical High $120.23 | Professional | None | $52.48 | $91.20 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $83.18 Typical High $102.33 | Facility | None | $67.61 | $83.18 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $245.47 | Professional | None | $141.25 | $199.53 | $245.47 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $630.96 Typical High $2,290.87 | Facility | None | $112.20 | $630.96 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $776.25 | Professional | None | $123.03 | $208.93 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $257.04 | Professional | None | $144.54 | $208.93 | $257.04 |
Midlands Setting Facility Modifier None Typical Low $67.61 Median $89.13 Typical High $109.65 | Facility | None | $67.61 | $89.13 | $109.65 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $223.87 | Professional | None | $123.03 | $194.98 | $223.87 |
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 $93.33 Median $151.36 Typical High $234.42 | Professional | None | $93.33 | $151.36 | $234.42 |
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 $30.20 Median $30.20 Typical High $47.86 | Professional | 52 · Reduced service | $30.20 | $30.20 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $19.05 | Professional | 53 · Discontinued | $12.02 | $12.02 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $70.79 | Professional | 54 · Surgery only | $44.67 | $44.67 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $14.13 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $9.55 |
Where Nebraska sits
The same service costs 3.6 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· 24th of 51
$112
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.