How much rates vary
Facilitymedian $1,862 · 10th to 90th $955 to $7,586Professionalmedian $331 · 10th to 90th $170 to $1,349
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 $302.00 Median $4,466.84 Typical High $11,481.54 | Facility | None | $302.00 | $4,466.84 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $562.34 | Professional | None | $169.82 | $302.00 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $758.58 | Professional | None | $302.00 | $302.00 | $758.58 |
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 $151.36 Median $263.03 Typical High $363.08 | Professional | None | $151.36 | $263.03 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,548.82 Typical High $1,905.46 | Facility | None | $954.99 | $1,548.82 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $707.95 Typical High $776.25 | Professional | None | $407.38 | $707.95 | $776.25 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $1,819.70 Typical High $5,754.40 | Facility | None | $588.84 | $1,819.70 | $5,754.40 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $1,348.96 Typical High $2,454.71 | Professional | None | $537.03 | $1,348.96 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $426.58 Median $724.44 Typical High $831.76 | Professional | None | $426.58 | $724.44 | $831.76 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,584.89 Typical High $1,995.26 | Facility | None | $954.99 | $1,584.89 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $354.81 Median $724.44 Typical High $831.76 | Professional | None | $354.81 | $724.44 | $831.76 |
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 $281.84 Median $457.09 Typical High $812.83 | Professional | None | $281.84 | $457.09 | $812.83 |
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 $85.11 Median $151.36 Typical High $162.18 | Professional | 52 · Reduced service | $85.11 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $33.88 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $229.09 Typical High $239.88 | Professional | 54 · Surgery only | $128.82 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $45.71 Typical High $47.86 | Professional | 55 · Aftercare only | $25.70 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $30.20 Typical High $32.36 | Professional | 56 · Pre-op care only | $16.98 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $213.80 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $120.23 | $213.80 | $223.87 |
Where Nebraska sits
The same service costs 6.3 times more in Colorado than in Montana. 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
CO $4,654MT $736
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.