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 $77.62 Median $77.62 Typical High $107.15 | Facility | None | $77.62 | $77.62 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $239.88 | Professional | None | $77.62 | $107.15 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $190.55 | Professional | None | $95.50 | $151.36 | $190.55 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $112.20 Median $158.49 Typical High $204.17 | Professional | 25 · Same-day visit | $112.20 | $158.49 | $204.17 |
BCBS Nebraska Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $275.42 | Facility | None | $234.42 | $234.42 | $275.42 |
BCBS Nebraska Setting Professional Modifier None Typical Low $67.61 Median $114.82 Typical High $154.88 | Professional | None | $67.61 | $114.82 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $281.84 | Professional | None | $144.54 | $218.78 | $281.84 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $194.98 Typical High $354.81 | Facility | None | $125.89 | $194.98 | $354.81 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $288.40 Typical High $724.44 | Professional | None | $134.90 | $288.40 | $724.44 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $186.21 Median $218.78 Typical High $269.15 | Professional | 25 · Same-day visit | $186.21 | $218.78 | $269.15 |
Midlands Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $288.40 | Professional | None | $165.96 | $223.87 | $288.40 |
Midlands Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $302.00 | Professional | None | $165.96 | $239.88 | $302.00 |
United Setting Professional Modifier None Typical Low $102.33 Median $194.98 Typical High $295.12 | Professional | None | $102.33 | $194.98 | $295.12 |
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 $38.90 Median $42.66 Typical High $53.70 | Professional | 52 · Reduced service | $38.90 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.59 Typical High $16.22 | Professional | 55 · Aftercare only | $11.75 | $12.59 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.51 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.76 | $8.51 | $10.72 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $109.65 Median $128.82 Typical High $204.17 | Professional | EP · Child screening program | $109.65 | $128.82 | $204.17 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | GC · Resident with teaching physician | $123.03 | $123.03 | $123.03 |
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· 11th of 51
$145
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.