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 $177.83 Median $3,801.89 Typical High $11,481.54 | Facility | None | $177.83 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $275.42 Typical High $467.74 | Professional | None | $123.03 | $275.42 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $257.04 | Professional | None | $165.96 | $165.96 | $257.04 |
BCBS Nebraska Setting Facility Modifier None Typical Low $537.03 Median $707.95 Typical High $1,445.44 | Facility | None | $537.03 | $707.95 | $1,445.44 |
BCBS Nebraska Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $234.42 | Professional | None | $102.33 | $177.83 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $213.80 Typical High $257.04 | Facility | None | $154.88 | $213.80 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $436.52 | Professional | None | $275.42 | $371.54 | $436.52 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $660.69 Typical High $2,290.87 | Facility | None | $218.78 | $660.69 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $426.58 Typical High $1,380.38 | Professional | None | $245.47 | $426.58 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $478.63 | Professional | None | $275.42 | $380.19 | $478.63 |
Midlands Setting Facility Modifier None Typical Low $147.91 Median $218.78 Typical High $263.03 | Facility | None | $147.91 | $218.78 | $263.03 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $407.38 | Professional | None | $239.88 | $354.81 | $407.38 |
United Setting Facility Modifier None Typical Low $467.74 Median $851.14 Typical High $2,754.23 | Facility | None | $467.74 | $851.14 | $2,754.23 |
United Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $457.09 | Professional | None | $169.82 | $281.84 | $457.09 |
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 $61.66 Median $61.66 Typical High $89.13 | Professional | 52 · Reduced service | $61.66 | $61.66 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $35.48 | Professional | 53 · Discontinued | $24.55 | $24.55 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $134.90 | Professional | 54 · Surgery only | $91.20 | $91.20 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $26.92 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $85.11 | $85.11 | $125.89 |
Where Nebraska sits
The same service costs 4.1 times more in Alaska 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· 19th of 51
$229
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.