How much rates vary
Facilitymedian $2,239 · 10th to 90th $589 to $8,318Professionalmedian $372 · 10th to 90th $209 to $692
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 $457.09 Median $2,344.23 Typical High $10,964.78 | Facility | None | $457.09 | $2,344.23 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $724.44 | Professional | None | $213.80 | $281.84 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
BCBS Nebraska Setting Facility Modifier None Typical Low $5,888.44 Median $7,762.47 Typical High $15,848.93 | Facility | None | $5,888.44 | $7,762.47 | $15,848.93 |
BCBS Nebraska Setting Professional Modifier None Typical Low $190.55 Median $338.84 Typical High $457.09 | Professional | None | $190.55 | $338.84 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,137.96 Typical High $3,019.95 | Facility | None | $954.99 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $707.95 | Professional | None | $512.86 | $588.84 | $707.95 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $1,819.70 Typical High $7,943.28 | Facility | None | $537.03 | $1,819.70 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $616.60 Typical High $2,238.72 | Professional | None | $354.81 | $616.60 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $741.31 | Professional | None | $512.86 | $616.60 | $741.31 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $2,238.72 Typical High $3,235.94 | Facility | None | $954.99 | $2,238.72 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $645.65 | Professional | None | $446.68 | $562.34 | $645.65 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $5,495.41 | Facility | None | $1,174.90 | $1,862.09 | $5,495.41 |
United Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $691.83 | Professional | None | $323.59 | $512.86 | $691.83 |
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 $107.15 Median $107.15 Typical High $138.04 | Professional | 52 · Reduced service | $107.15 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $54.95 | Professional | 53 · Discontinued | $42.66 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $204.17 | Professional | 54 · Surgery only | $162.18 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $40.74 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $190.55 |
Where Nebraska sits
The same service costs 8.5 times more in Alaska than in West Virginia. 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
AK $5,029WV $590
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.