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 $147.91 Median $147.91 Typical High $269.15 | Facility | None | $147.91 | $147.91 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $389.05 | Professional | None | $147.91 | $147.91 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $281.84 | Professional | None | $125.89 | $134.90 | $281.84 |
BCBS Nebraska Setting Facility Modifier None Typical Low $125.89 Median $154.88 Typical High $169.82 | Facility | None | $125.89 | $154.88 | $169.82 |
BCBS Nebraska Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | None | $158.49 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $186.21 | Professional | None | $154.88 | $162.18 | $186.21 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $257.04 Typical High $1,445.44 | Facility | None | $134.90 | $257.04 | $1,445.44 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $1,348.96 | Professional | None | $134.90 | $162.18 | $1,348.96 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $186.21 | Professional | None | $162.18 | $169.82 | $186.21 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $338.84 | Professional | None | $169.82 | $169.82 | $338.84 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $128.82 Median $134.90 Typical High $354.81 | Professional | None | $128.82 | $134.90 | $354.81 |
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 $74.13 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $14.79 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $134.90 Median $134.90 Typical High $147.91 | Professional | JZ · No drug discarded | $134.90 | $134.90 | $147.91 |
Where Nebraska sits
The same service costs 2.4 times more in Wyoming than in New York. 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· 8th of 51
$162
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.