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 $134.90 Median $3,548.13 Typical High $11,481.54 | Facility | None | $134.90 | $3,548.13 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $229.09 Typical High $354.81 | Professional | None | $107.15 | $229.09 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $281.84 | Professional | None | $104.71 | $141.25 | $281.84 |
BCBS Nebraska Setting Facility Modifier None Typical Low $467.74 Median $954.99 Typical High $1,995.26 | Facility | None | $467.74 | $954.99 | $1,995.26 |
BCBS Nebraska Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $213.80 | Professional | None | $93.33 | $158.49 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $120.23 Typical High $138.04 | Facility | None | $97.72 | $120.23 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $346.74 | Professional | None | $229.09 | $275.42 | $346.74 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $245.47 Typical High $1,000.00 | Facility | None | $102.33 | $245.47 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $346.74 Typical High $1,096.48 | Professional | None | $173.78 | $346.74 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $371.54 | Professional | None | $269.15 | $323.59 | $371.54 |
Midlands Setting Facility Modifier None Typical Low $100.00 Median $123.03 Typical High $186.21 | Facility | None | $100.00 | $123.03 | $186.21 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $371.54 Typical High $478.63 | Professional | None | $194.98 | $371.54 | $478.63 |
United Setting Facility Modifier None Typical Low $104.71 Median $251.19 Typical High $1,230.27 | Facility | None | $104.71 | $251.19 | $1,230.27 |
United Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $354.81 | Professional | None | $151.36 | $257.04 | $354.81 |
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 $53.70 Median $67.61 Typical High $95.50 | Professional | 52 · Reduced service | $53.70 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $26.92 Typical High $38.02 | Professional | 53 · Discontinued | $21.38 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $102.33 Typical High $144.54 | Professional | 54 · Surgery only | $81.28 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.42 Typical High $28.84 | Professional | 55 · Aftercare only | $16.22 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.72 | $13.49 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $95.50 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $75.86 | $95.50 | $134.90 |
Where Nebraska sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 13th of 51
$195
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.