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 $162.18 Median $3,801.89 Typical High $11,481.54 | Facility | None | $162.18 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $309.03 | Professional | None | $104.71 | $162.18 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $338.84 | Professional | None | $229.09 | $229.09 | $338.84 |
BCBS Nebraska Setting Facility Modifier None Typical Low $3,162.28 Median $4,168.69 Typical High $8,511.38 | Facility | None | $3,162.28 | $4,168.69 | $8,511.38 |
BCBS Nebraska Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $218.78 | Professional | None | $91.20 | $162.18 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,621.81 Typical High $2,187.76 | Facility | None | $645.65 | $1,621.81 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $426.58 | Professional | None | $245.47 | $389.05 | $426.58 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $1,122.02 Typical High $6,918.31 | Facility | None | $316.23 | $1,122.02 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $831.76 Typical High $1,318.26 | Professional | None | $275.42 | $831.76 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $446.68 | Professional | None | $257.04 | $389.05 | $446.68 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $1,819.70 Typical High $2,344.23 | Facility | None | $645.65 | $1,819.70 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $389.05 Typical High $446.68 | Professional | None | $218.78 | $389.05 | $446.68 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $3,311.31 | Facility | None | $707.95 | $1,445.44 | $3,311.31 |
United Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $436.52 | Professional | None | $169.82 | $275.42 | $436.52 |
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 $52.48 Median $81.28 Typical High $97.72 | Professional | 52 · Reduced service | $52.48 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $32.36 Typical High $38.90 | Professional | 53 · Discontinued | $20.89 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $123.03 Typical High $147.91 | Professional | 54 · Surgery only | $77.62 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $24.55 Typical High $29.51 | Professional | 55 · Aftercare only | $15.49 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $16.22 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.47 | $16.22 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $114.82 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $72.44 | $114.82 | $138.04 |
Where Nebraska sits
The same service costs 4.8 times more in Alaska 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.
Nebraska· 13th of 51
$229
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.