How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $107.15 Median $107.15 Typical High $141.25 | Facility | None | $107.15 | $107.15 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $316.23 | Professional | None | $107.15 | $141.25 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $251.19 | Professional | None | $125.89 | $204.17 | $251.19 |
BCBS Nebraska Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $363.08 | Facility | None | $309.03 | $309.03 | $363.08 |
BCBS Nebraska Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $213.80 | Professional | None | $93.33 | $158.49 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $363.08 | Professional | None | $199.53 | $288.40 | $363.08 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $251.19 Typical High $489.78 | Facility | None | $169.82 | $251.19 | $489.78 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $363.08 Typical High $954.99 | Professional | None | $173.78 | $363.08 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $380.19 | Professional | None | $229.09 | $288.40 | $380.19 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $389.05 | Professional | None | $223.87 | $316.23 | $389.05 |
Oscar Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $288.40 | Professional | None | $102.33 | $102.33 | $288.40 |
United Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $389.05 | Professional | None | $138.04 | $257.04 | $389.05 |
7 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 $53.70 Median $57.54 Typical High $70.79 | Professional | 52 · Reduced service | $53.70 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $20.89 | Professional | 55 · Aftercare only | $16.22 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.48 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.72 | $11.48 | $14.13 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $125.89 Median $186.21 Typical High $251.19 | Professional | 25 · Same-day visit | $125.89 | $186.21 | $251.19 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | GC · Resident with teaching physician | $173.78 | $173.78 | $173.78 |
Ambetter Setting Professional Modifier GF · Non-physician, rural hospital Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | GF · Non-physician, rural hospital | $125.89 | $125.89 | $125.89 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $257.04 Median $302.00 Typical High $354.81 | Professional | 25 · Same-day visit | $257.04 | $302.00 | $354.81 |
Where Nebraska sits
The same service costs 2.7 times more in Alaska than in Washington, DC. 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· 12th of 51
$191
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.