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 $138.04 Median $3,801.89 Typical High $11,481.54 | Facility | None | $138.04 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $181.97 Typical High $363.08 | Professional | None | $91.20 | $181.97 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $346.74 | Professional | None | $281.84 | $295.12 | $346.74 |
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 $81.28 Median $138.04 Typical High $186.21 | Professional | None | $81.28 | $138.04 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $125.89 Typical High $141.25 | Facility | None | $100.00 | $125.89 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $363.08 | Professional | None | $218.78 | $302.00 | $363.08 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $239.88 Typical High $1,288.25 | Facility | None | $102.33 | $239.88 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $1,122.02 | Professional | None | $186.21 | $316.23 | $1,122.02 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $371.54 | Professional | None | $223.87 | $309.03 | $371.54 |
Midlands Setting Facility Modifier None Typical Low $100.00 Median $125.89 Typical High $147.91 | Facility | None | $100.00 | $125.89 | $147.91 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $331.13 | Professional | None | $190.55 | $288.40 | $331.13 |
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 $144.54 Median $234.42 Typical High $354.81 | Professional | None | $144.54 | $234.42 | $354.81 |
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 $45.71 Median $45.71 Typical High $69.18 | Professional | 52 · Reduced service | $45.71 | $45.71 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $28.18 | Professional | 53 · Discontinued | $18.62 | $18.62 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $104.71 | Professional | 54 · Surgery only | $69.18 | $69.18 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $20.89 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $13.80 |
Where Nebraska sits
The same service costs 3.2 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· 23rd of 51
$174
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.