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 $177.83 Typical High $389.05 | Facility | None | $177.83 | $177.83 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $416.87 | Professional | None | $162.18 | $177.83 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
BCBS Nebraska Setting Facility Modifier None Typical Low $371.54 Median $457.09 Typical High $501.19 | Facility | None | $371.54 | $457.09 | $501.19 |
BCBS Nebraska Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | None | $954.99 | $1,000.00 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $263.03 | Professional | None | $213.80 | $234.42 | $263.03 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $407.38 Typical High $1,412.54 | Facility | None | $154.88 | $407.38 | $1,412.54 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $363.08 | Professional | None | $154.88 | $173.78 | $363.08 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $239.88 Typical High $263.03 | Professional | None | $234.42 | $239.88 | $263.03 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $346.74 | Professional | None | $223.87 | $245.47 | $346.74 |
United Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $524.81 | Professional | None | $165.96 | $177.83 | $524.81 |
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 $79.43 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $79.43 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $35.48 | Professional | 53 · Discontinued | $32.36 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $26.30 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $17.78 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $162.18 Median $162.18 Typical High $363.08 | Professional | JZ · No drug discarded | $162.18 | $162.18 | $363.08 |
Where Nebraska sits
The same service costs 1.9 times more in Wyoming than in Nevada. 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· 4th of 51
$209
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.