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 $512.86 Median $7,585.78 Typical High $19,952.62 | Facility | None | $512.86 | $7,585.78 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $933.25 | Professional | None | $407.38 | $512.86 | $933.25 |
BCBS Nebraska Setting Facility Modifier None Typical Low $5,248.07 Median $6,918.31 Typical High $14,125.38 | Facility | None | $5,248.07 | $6,918.31 | $14,125.38 |
BCBS Nebraska Setting Professional Modifier None Typical Low $354.81 Median $630.96 Typical High $870.96 | Professional | None | $354.81 | $630.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $1,905.46 | Facility | None | $1,202.26 | $1,548.82 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,318.26 | Professional | None | $954.99 | $1,202.26 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $1,819.70 Typical High $5,754.40 | Facility | None | $851.14 | $1,819.70 | $5,754.40 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $3,630.78 Typical High $4,677.35 | Professional | None | $933.25 | $3,630.78 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,258.93 | $1,380.38 |
Midlands Setting Facility Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $1,995.26 | Facility | None | $1,288.25 | $1,584.89 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,380.38 | Professional | None | $851.14 | $1,230.27 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $5,495.41 | Facility | None | $1,174.90 | $1,862.09 | $5,495.41 |
United Setting Professional Modifier None Typical Low $616.60 Median $1,023.29 Typical High $1,348.96 | Professional | None | $616.60 | $1,023.29 | $1,348.96 |
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 $204.17 Median $251.19 Typical High $380.19 | Professional | 52 · Reduced service | $204.17 | $251.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $102.33 Typical High $154.88 | Professional | 53 · Discontinued | $81.28 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $380.19 Typical High $575.44 | Professional | 54 · Surgery only | $309.03 | $380.19 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $75.86 Typical High $114.82 | Professional | 55 · Aftercare only | $61.66 | $75.86 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $51.29 Typical High $77.62 | Professional | 56 · Pre-op care only | $40.74 | $51.29 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $354.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $288.40 | $354.81 | $537.03 |
Where Nebraska sits
The same service costs 6.5 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· 11th of 51
$851
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.