How much rates vary
Facilitymedian $1,905 · 10th to 90th $1,096 to $8,318Professionalmedian $794 · 10th to 90th $427 to $1,549
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 $549.54 Median $7,244.36 Typical High $17,378.01 | Facility | None | $549.54 | $7,244.36 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $1,445.44 | Professional | None | $426.58 | $549.54 | $1,445.44 |
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 $371.54 Median $660.69 Typical High $891.25 | Professional | None | $371.54 | $660.69 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $1,905.46 | Facility | None | $1,096.48 | $1,548.82 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,288.25 | $1,412.54 |
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 $870.96 Median $1,621.81 Typical High $4,365.16 | Professional | None | $870.96 | $1,621.81 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,348.96 | $1,479.11 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $1,995.26 | Facility | None | $1,096.48 | $1,584.89 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,479.11 | Professional | None | $891.25 | $1,318.26 | $1,479.11 |
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 $660.69 Median $1,071.52 Typical High $1,445.44 | Professional | None | $660.69 | $1,071.52 | $1,445.44 |
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 $213.80 Median $275.42 Typical High $398.11 | Professional | 52 · Reduced service | $213.80 | $275.42 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $109.65 Typical High $158.49 | Professional | 53 · Discontinued | $85.11 | $109.65 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $407.38 Typical High $602.56 | Professional | 54 · Surgery only | $316.23 | $407.38 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $81.28 Typical High $120.23 | Professional | 55 · Aftercare only | $63.10 | $81.28 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $54.95 Typical High $79.43 | Professional | 56 · Pre-op care only | $42.66 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $380.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $295.12 | $380.19 | $562.34 |
Where Nebraska sits
The same service costs 4.0 times more in Oklahoma than in West Virginia. 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.
Physician feeFacility fee
OK $5,056WV $1,262
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.