How much rates vary
Facilitymedian $5,754 · 10th to 90th $2,291 to $11,482Professionalmedian $2,570 · 10th to 90th $1,380 to $5,754
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 $4,677.35 Median $7,943.28 Typical High $21,877.62 | Facility | None | $4,677.35 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,445.44 | $2,398.83 |
BCBS Nebraska Setting Facility Modifier None Typical Low $6,760.83 Median $8,912.51 Typical High $18,197.01 | Facility | None | $6,760.83 | $8,912.51 | $18,197.01 |
BCBS Nebraska Setting Professional Modifier None Typical Low $5,011.87 Median $5,370.32 Typical High $5,754.40 | Professional | None | $5,011.87 | $5,370.32 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $5,128.61 Typical High $6,606.93 | Facility | None | $4,073.80 | $5,128.61 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $2,754.23 | Professional | None | $2,187.76 | $2,511.89 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $1,584.89 Median $3,715.35 Typical High $12,022.64 | Facility | None | $1,584.89 | $3,715.35 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $1,380.38 Median $2,630.27 Typical High $8,709.64 | Professional | None | $1,380.38 | $2,630.27 | $8,709.64 |
Midlands Setting Professional Modifier None Typical Low $2,238.72 Median $2,570.40 Typical High $3,388.44 | Professional | None | $2,238.72 | $2,570.40 | $3,388.44 |
Midlands Setting Facility Modifier None Typical Low $3,981.07 Median $5,495.41 Typical High $8,912.51 | Facility | None | $3,981.07 | $5,495.41 | $8,912.51 |
Midlands Setting Professional Modifier None Typical Low $1,949.84 Median $2,754.23 Typical High $3,715.35 | Professional | None | $1,949.84 | $2,754.23 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $8,912.51 | Facility | None | $1,698.24 | $3,801.89 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $2,290.87 Typical High $3,162.28 | Professional | None | $1,380.38 | $2,290.87 | $3,162.28 |
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 $537.03 Median $537.03 Typical High $954.99 | Professional | 52 · Reduced service | $537.03 | $537.03 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $380.19 | Professional | 53 · Discontinued | $213.80 | $213.80 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $1,412.54 | Professional | 54 · Surgery only | $812.83 | $812.83 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $281.84 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $190.55 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $1,318.26 |
Where Nebraska sits
The same service costs 5.5 times more in Colorado 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
CO $14,842WV $2,709
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.