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 $67.61 Median $7,585.78 Typical High $12,589.25 | Facility | None | $67.61 | $7,585.78 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $89.13 Typical High $165.96 | Professional | None | $41.69 | $89.13 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $162.18 | Professional | None | $58.88 | $58.88 | $162.18 |
BCBS Nebraska Setting Facility Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $4,466.84 | Facility | None | $1,621.81 | $2,187.76 | $4,466.84 |
BCBS Nebraska Setting Professional Modifier None Typical Low $37.15 Median $63.10 Typical High $83.18 | Professional | None | $37.15 | $63.10 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $64.57 Typical High $85.11 | Facility | None | $45.71 | $64.57 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $177.83 | Professional | None | $97.72 | $141.25 | $177.83 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $208.93 Typical High $1,288.25 | Facility | None | $72.44 | $208.93 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $158.49 Typical High $549.54 | Professional | None | $87.10 | $158.49 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $173.78 | Professional | None | $102.33 | $141.25 | $173.78 |
Midlands Setting Facility Modifier None Typical Low $48.98 Median $66.07 Typical High $89.13 | Facility | None | $48.98 | $66.07 | $89.13 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $162.18 | Professional | None | $87.10 | $138.04 | $162.18 |
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 $66.07 Median $107.15 Typical High $169.82 | Professional | None | $66.07 | $107.15 | $169.82 |
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 $20.89 Median $20.89 Typical High $33.88 | Professional | 52 · Reduced service | $20.89 | $20.89 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $13.49 | Professional | 53 · Discontinued | $8.32 | $8.32 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $51.29 | Professional | 54 · Surgery only | $31.62 | $31.62 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $10.23 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $6.76 |
Where Nebraska sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 26th of 51
$81.28
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.