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 $7,585.78 Typical High $12,589.25 | Facility | None | $138.04 | $7,585.78 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $239.88 | Professional | None | $112.20 | $138.04 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
BCBS Nebraska Setting Facility Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $6,456.54 | Facility | None | $2,344.23 | $3,162.28 | $6,456.54 |
BCBS Nebraska Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $229.09 | Professional | None | $100.00 | $169.82 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $112.20 Typical High $125.89 | Facility | None | $93.33 | $112.20 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $380.19 | Professional | None | $269.15 | $302.00 | $380.19 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $630.96 Typical High $2,290.87 | Facility | None | $213.80 | $630.96 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $346.74 Typical High $3,019.95 | Professional | None | $177.83 | $346.74 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $398.11 | Professional | None | $275.42 | $338.84 | $398.11 |
Midlands Setting Facility Modifier None Typical Low $93.33 Median $109.65 Typical High $134.90 | Facility | None | $93.33 | $109.65 | $134.90 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $331.13 | Professional | None | $234.42 | $288.40 | $331.13 |
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 $169.82 Median $275.42 Typical High $371.54 | Professional | None | $169.82 | $275.42 | $371.54 |
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 $56.23 Median $56.23 Typical High $69.18 | Professional | 52 · Reduced service | $56.23 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $27.54 | Professional | 53 · Discontinued | $22.39 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | 54 · Surgery only | $85.11 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $20.89 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $13.80 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $13.80 |
Where Nebraska sits
The same service costs 2.9 times more in Alaska 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· 16th of 51
$209
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.