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 $831.76 Median $7,943.28 Typical High $21,877.62 | Facility | None | $831.76 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,479.11 | Professional | None | $831.76 | $831.76 | $1,479.11 |
BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $8,709.64 Typical High $17,782.79 | Facility | None | $6,456.54 | $8,709.64 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,137.96 | Professional | None | $1,659.59 | $1,949.84 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $4,365.16 | Facility | None | $478.63 | $954.99 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $2,089.30 Typical High $9,772.37 | Professional | None | $1,096.48 | $2,089.30 | $9,772.37 |
Midlands Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,659.59 | $2,041.74 | $2,691.53 |
Midlands Setting Professional Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,513.56 | $2,089.30 | $2,884.03 |
United Setting Facility Modifier None Typical Low $489.78 Median $891.25 Typical High $3,801.89 | Facility | None | $489.78 | $891.25 | $3,801.89 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,096.48 | $1,819.70 | $2,511.89 |
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 $416.87 Median $416.87 Typical High $724.44 | Professional | 52 · Reduced service | $416.87 | $416.87 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $295.12 | Professional | 53 · Discontinued | $165.96 | $165.96 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $1,096.48 | Professional | 54 · Surgery only | $616.60 | $616.60 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $218.78 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $147.91 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $1,023.29 |
Where Nebraska sits
The same service costs 24.0 times more in Alaska than in Texas. 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· 4th of 51
$1,950
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.