How much rates vary
Facilitymedian $79 · 10th to 90th $48 to $135Professionalmedian $55 · 10th to 90th $31 to $112
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 $35.48 Median $58.88 Typical High $112.20 | Facility | None | $35.48 | $58.88 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $42.66 Typical High $91.20 | Professional | None | $23.99 | $42.66 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $36.31 Median $61.66 Typical High $100.00 | Professional | None | $36.31 | $61.66 | $100.00 |
BCBS Nebraska Setting Facility Modifier None Typical Low $75.86 Median $79.43 Typical High $81.28 | Facility | None | $75.86 | $79.43 | $81.28 |
BCBS Nebraska Setting Professional Modifier None Typical Low $28.84 Median $50.12 Typical High $66.07 | Professional | None | $28.84 | $50.12 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $79.43 Typical High $125.89 | Professional | None | $41.69 | $79.43 | $125.89 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $89.13 Typical High $181.97 | Facility | None | $51.29 | $89.13 | $181.97 |
Medica Setting Professional Modifier None Typical Low $51.29 Median $112.20 Typical High $354.81 | Professional | None | $51.29 | $112.20 | $354.81 |
Midlands Setting Professional Modifier None Typical Low $47.86 Median $85.11 Typical High $147.91 | Professional | None | $47.86 | $85.11 | $147.91 |
Midlands Setting Professional Modifier None Typical Low $69.18 Median $114.82 Typical High $147.91 | Professional | None | $69.18 | $114.82 | $147.91 |
Oscar Health Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $102.33 | Professional | None | $46.77 | $51.29 | $102.33 |
United Setting Professional Modifier None Typical Low $30.20 Median $60.26 Typical High $112.20 | Professional | None | $30.20 | $60.26 | $112.20 |
10 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 $15.49 Median $17.38 Typical High $25.12 | Professional | 52 · Reduced service | $15.49 | $17.38 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $5.25 Typical High $7.41 | Professional | 55 · Aftercare only | $4.68 | $5.25 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.47 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.09 | $3.47 | $5.01 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $128.82 Median $128.82 Typical High $138.04 | Professional | 24 · Unrelated visit after surgery | $128.82 | $128.82 | $138.04 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $46.77 Median $66.07 Typical High $125.89 | Professional | 25 · Same-day visit | $46.77 | $66.07 | $125.89 |
Ambetter Setting Professional Modifier FQ · Audio-only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | FQ · Audio-only | $83.18 | $83.18 | $83.18 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | FS · Shared visit | $60.26 | $60.26 | $60.26 |
Ambetter Setting Professional Modifier GF · Non-physician, rural hospital Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | GF · Non-physician, rural hospital | $44.67 | $44.67 | $52.48 |
Medica Setting Facility Modifier 25 · Same-day visit Typical Low $48.98 Median $89.13 Typical High $144.54 | Facility | 25 · Same-day visit | $48.98 | $89.13 | $144.54 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $69.18 Median $97.72 Typical High $123.03 | Professional | 25 · Same-day visit | $69.18 | $97.72 | $123.03 |
Where Nebraska sits
The same service costs 2.4 times more in Alaska than in New Jersey. 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
$54.95
AK $77.62NJ $32.36
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.