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 $7.24 Median $7,943.28 Typical High $21,877.62 | Facility | None | $7.24 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
BCBS Nebraska Setting Facility Modifier None Typical Low $302.00 Median $524.81 Typical High $1,096.48 | Facility | None | $302.00 | $524.81 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $13.49 Typical High $19.05 | Professional | None | $13.18 | $13.49 | $19.05 |
Medica Setting Facility Modifier None Typical Low $14.13 Median $128.82 Typical High $263.03 | Facility | None | $14.13 | $128.82 | $263.03 |
Medica Setting Professional Modifier None Typical Low $13.80 Median $19.50 Typical High $380.19 | Professional | None | $13.80 | $19.50 | $380.19 |
Midlands Setting Professional Modifier None Typical Low $15.49 Median $16.22 Typical High $20.89 | Professional | None | $15.49 | $16.22 | $20.89 |
Midlands Setting Professional Modifier None Typical Low $12.30 Median $16.22 Typical High $20.42 | Professional | None | $12.30 | $16.22 | $20.42 |
United Setting Facility Modifier None Typical Low $158.49 Median $169.82 Typical High $218.78 | Facility | None | $158.49 | $169.82 | $218.78 |
United Setting Professional Modifier None Typical Low $12.88 Median $18.20 Typical High $20.42 | Professional | None | $12.88 | $18.20 | $20.42 |
5 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 $3.63 Median $3.63 Typical High $3.63 | Professional | 52 · Reduced service | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 53 · Discontinued | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 54 · Surgery only | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 55 · Aftercare only | $1.10 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.72 | $0.72 | $0.72 |
Where Nebraska sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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· 7th of 51
$15.85
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.