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 $102.33 Median $3,801.89 Typical High $11,481.54 | Facility | None | $102.33 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $125.89 Typical High $269.15 | Professional | None | $51.29 | $125.89 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $74.13 | Professional | None | $70.79 | $74.13 | $74.13 |
BCBS Nebraska Setting Facility Modifier None Typical Low $724.44 Median $977.24 Typical High $1,995.26 | Facility | None | $724.44 | $977.24 | $1,995.26 |
BCBS Nebraska Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $107.15 | Professional | None | $44.67 | $79.43 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $131.83 Typical High $151.36 | Facility | None | $104.71 | $131.83 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $316.23 | Professional | None | $120.23 | $223.87 | $316.23 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $630.96 Typical High $2,951.21 | Facility | None | $104.71 | $630.96 | $2,951.21 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $1,380.38 | Professional | None | $138.04 | $257.04 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $316.23 | Professional | None | $173.78 | $245.47 | $316.23 |
Midlands Setting Facility Modifier None Typical Low $104.71 Median $131.83 Typical High $158.49 | Facility | None | $104.71 | $131.83 | $158.49 |
Midlands Setting Professional Modifier None Typical Low $93.33 Median $186.21 Typical High $354.81 | Professional | None | $93.33 | $186.21 | $354.81 |
Oscar Health Setting Professional Modifier None Typical Low $53.70 Median $114.82 Typical High $251.19 | Professional | None | $53.70 | $114.82 | $251.19 |
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 $74.13 Median $147.91 Typical High $288.40 | Professional | None | $74.13 | $147.91 | $288.40 |
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 $25.70 Median $51.29 Typical High $67.61 | Professional | 52 · Reduced service | $25.70 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $20.42 Typical High $26.92 | Professional | 53 · Discontinued | $10.23 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $77.62 Typical High $100.00 | Professional | 54 · Surgery only | $38.90 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $15.49 Typical High $19.95 | Professional | 55 · Aftercare only | $7.76 | $15.49 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $10.23 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.13 | $10.23 | $13.49 |
Where Nebraska sits
The same service costs 3.2 times more in Alaska than in 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.
Nebraska· 46th of 51
$102
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.