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 $257.04 Median $4,466.84 Typical High $11,481.54 | Facility | None | $257.04 | $4,466.84 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $676.08 | Professional | None | $147.91 | $257.04 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $645.65 | Professional | None | $549.54 | $549.54 | $645.65 |
BCBS Nebraska Setting Facility Modifier None Typical Low $4,677.35 Median $6,309.57 Typical High $12,589.25 | Facility | None | $4,677.35 | $6,309.57 | $12,589.25 |
BCBS Nebraska Setting Professional Modifier None Typical Low $128.82 Median $229.09 Typical High $295.12 | Professional | None | $128.82 | $229.09 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $346.74 Typical High $407.38 | Facility | None | $288.40 | $346.74 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $602.56 Typical High $660.69 | Professional | None | $346.74 | $602.56 | $660.69 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $1,096.48 Typical High $3,715.35 | Facility | None | $478.63 | $1,096.48 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $1,174.90 Typical High $2,238.72 | Professional | None | $467.74 | $1,174.90 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $645.65 Typical High $691.83 | Professional | None | $363.08 | $645.65 | $691.83 |
Midlands Setting Facility Modifier None Typical Low $288.40 Median $346.74 Typical High $436.52 | Facility | None | $288.40 | $346.74 | $436.52 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $602.56 Typical High $691.83 | Professional | None | $309.03 | $602.56 | $691.83 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,348.96 Typical High $3,162.28 | Facility | None | $707.95 | $1,348.96 | $3,162.28 |
United Setting Professional Modifier None Typical Low $239.88 Median $398.11 Typical High $691.83 | Professional | None | $239.88 | $398.11 | $691.83 |
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 $74.13 Median $128.82 Typical High $138.04 | Professional | 52 · Reduced service | $74.13 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $51.29 Typical High $54.95 | Professional | 53 · Discontinued | $29.51 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $190.55 Typical High $208.93 | Professional | 54 · Surgery only | $109.65 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $38.02 Typical High $41.69 | Professional | 55 · Aftercare only | $21.88 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $25.70 Typical High $27.54 | Professional | 56 · Pre-op care only | $14.79 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $177.83 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $102.33 | $177.83 | $194.98 |
Where Nebraska sits
The same service costs 3.8 times more in Wyoming 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· 17th of 51
$316
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.