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 $575.44 Median $7,943.28 Typical High $21,877.62 | Facility | None | $575.44 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,023.29 | Professional | None | $575.44 | $575.44 | $1,023.29 |
BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $4,073.80 Typical High $8,317.64 | Facility | None | $3,090.30 | $4,073.80 | $8,317.64 |
BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,445.44 | $1,513.56 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $2,187.76 Typical High $3,890.45 | Facility | None | $1,479.11 | $2,187.76 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,174.90 | $1,348.96 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $1,995.26 Typical High $6,606.93 | Facility | None | $1,071.52 | $1,995.26 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,412.54 Typical High $4,677.35 | Professional | None | $758.58 | $1,412.54 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,412.54 | $1,862.09 |
Midlands Setting Facility Modifier None Typical Low $1,479.11 Median $2,187.76 Typical High $3,548.13 | Facility | None | $1,479.11 | $2,187.76 | $3,548.13 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,479.11 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,238.72 Typical High $6,309.57 | Facility | None | $1,288.25 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $1,584.89 | Professional | None | $758.58 | $1,230.27 | $1,584.89 |
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 $288.40 Median $288.40 Typical High $512.86 | Professional | 52 · Reduced service | $288.40 | $288.40 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $204.17 | Professional | 53 · Discontinued | $114.82 | $114.82 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $758.58 | Professional | 54 · Surgery only | $436.52 | $436.52 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $151.36 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $102.33 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $707.95 |
Where Nebraska sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$1,445
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.