How much rates vary
Facilitymedian $5,754 · 10th to 90th $2,291 to $11,482Professionalmedian $2,884 · 10th to 90th $1,514 to $5,623
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 $1,174.90 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,174.90 | $1,584.89 | $3,090.30 |
Ambetter Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,570.40 | Professional | None | $2,187.76 | $2,187.76 | $2,570.40 |
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 $2,344.23 Median $2,754.23 Typical High $3,019.95 | Professional | None | $2,344.23 | $2,754.23 | $3,019.95 |
Medica Setting Facility Modifier None Typical Low $1,584.89 Median $3,981.07 Typical High $18,197.01 | Facility | None | $1,584.89 | $3,981.07 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,513.56 Median $2,884.03 Typical High $10,471.29 | Professional | None | $1,513.56 | $2,884.03 | $10,471.29 |
Midlands Setting Professional Modifier None Typical Low $2,290.87 Median $2,884.03 Typical High $3,801.89 | Professional | None | $2,290.87 | $2,884.03 | $3,801.89 |
Midlands Setting Facility Modifier None Typical Low $4,073.80 Median $5,495.41 Typical High $8,912.51 | Facility | None | $4,073.80 | $5,495.41 | $8,912.51 |
Midlands Setting Professional Modifier None Typical Low $2,137.96 Median $2,884.03 Typical High $3,981.07 | Professional | None | $2,137.96 | $2,884.03 | $3,981.07 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,981.07 Typical High $8,912.51 | Facility | None | $1,698.24 | $3,981.07 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $3,467.37 | Professional | None | $1,513.56 | $2,511.89 | $3,467.37 |
7 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 $588.84 Median $588.84 Typical High $1,023.29 | Professional | 52 · Reduced service | $588.84 | $588.84 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $407.38 | Professional | 53 · Discontinued | $234.42 | $234.42 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,548.82 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $309.03 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $204.17 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $1,445.44 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 50 · Both sides | $380.19 | $380.19 | $380.19 |
Where Nebraska sits
The same service costs 4.7 times more in Colorado 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.
Physician feeFacility fee
CO $15,002KY $3,224
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.