How much rates vary
Facilitymedian $692 · 10th to 90th $355 to $3,802Professionalmedian $209 · 10th to 90th $107 to $427
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 $229.09 Median $1,548.82 Typical High $10,964.78 | Facility | None | $229.09 | $1,548.82 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $229.09 Typical High $389.05 | Professional | None | $107.15 | $229.09 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | None | $177.83 | $194.98 | $194.98 |
BCBS Nebraska Setting Facility Modifier None Typical Low $1,548.82 Median $2,041.74 Typical High $4,168.69 | Facility | None | $1,548.82 | $2,041.74 | $4,168.69 |
BCBS Nebraska Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $229.09 | Professional | None | $93.33 | $165.96 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $812.83 | Facility | None | $478.63 | $645.65 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $407.38 | Professional | None | $229.09 | $338.84 | $407.38 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $707.95 Typical High $2,290.87 | Facility | None | $371.54 | $707.95 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $407.38 Typical High $1,258.93 | Professional | None | $213.80 | $407.38 | $1,258.93 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $426.58 | Professional | None | $269.15 | $354.81 | $426.58 |
Midlands Setting Facility Modifier None Typical Low $524.81 Median $645.65 Typical High $812.83 | Facility | None | $524.81 | $645.65 | $812.83 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $354.81 Typical High $524.81 | Professional | None | $194.98 | $354.81 | $524.81 |
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 $154.88 Median $257.04 Typical High $426.58 | Professional | None | $154.88 | $257.04 | $426.58 |
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 $53.70 Median $79.43 Typical High $93.33 | Professional | 52 · Reduced service | $53.70 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $31.62 Typical High $37.15 | Professional | 53 · Discontinued | $21.38 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $117.49 Typical High $138.04 | Professional | 54 · Surgery only | $81.28 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $23.44 Typical High $27.54 | Professional | 55 · Aftercare only | $16.22 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.85 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.72 | $15.85 | $18.62 |
Where Nebraska sits
The same service costs 6.3 times more in New York than in Montana. 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
NY $2,712MT $427
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.