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 $134.90 Median $3,801.89 Typical High $11,481.54 | Facility | None | $134.90 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $354.81 | Professional | None | $109.65 | $134.90 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
BCBS Nebraska Setting Facility Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $3,388.44 | Facility | None | $1,258.93 | $1,659.59 | $3,388.44 |
BCBS Nebraska Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $218.78 | Professional | None | $97.72 | $165.96 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $165.96 Typical High $194.98 | Facility | None | $134.90 | $165.96 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $354.81 | Professional | None | $263.03 | $323.59 | $354.81 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $239.88 Typical High $1,288.25 | Facility | None | $102.33 | $239.88 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $870.96 Typical High $1,148.15 | Professional | None | $251.19 | $870.96 | $1,148.15 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $363.08 | Professional | None | $275.42 | $346.74 | $363.08 |
Midlands Setting Facility Modifier None Typical Low $134.90 Median $165.96 Typical High $208.93 | Facility | None | $134.90 | $165.96 | $208.93 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $363.08 | Professional | None | $229.09 | $331.13 | $363.08 |
United Setting Facility Modifier None Typical Low $104.71 Median $251.19 Typical High $1,230.27 | Facility | None | $104.71 | $251.19 | $1,230.27 |
United Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $371.54 | Professional | None | $169.82 | $281.84 | $371.54 |
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 $54.95 Median $67.61 Typical High $102.33 | Professional | 52 · Reduced service | $54.95 | $67.61 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.92 Typical High $41.69 | Professional | 53 · Discontinued | $21.88 | $26.92 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $100.00 Typical High $154.88 | Professional | 54 · Surgery only | $83.18 | $100.00 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.42 Typical High $30.90 | Professional | 55 · Aftercare only | $16.60 | $20.42 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.49 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.96 | $13.49 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $93.33 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $77.62 | $93.33 | $144.54 |
Where Nebraska sits
The same service costs 4.1 times more in Alaska than in Florida. 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
$209
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.