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 $436.52 Median $436.52 Typical High $446.68 | Facility | None | $436.52 | $436.52 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $676.08 | Professional | None | $436.52 | $436.52 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Facility | None | $891.25 | $891.25 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $1,071.52 Typical High $1,380.38 | Professional | None | $537.03 | $1,071.52 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $776.25 Typical High $2,344.23 | Facility | None | $436.52 | $776.25 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $630.96 Typical High $16,595.87 | Professional | None | $363.08 | $630.96 | $16,595.87 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $2,511.89 | Facility | None | $758.58 | $1,288.25 | $2,511.89 |
United Setting Professional Modifier None Typical Low $338.84 Median $630.96 Typical High $933.25 | Professional | None | $338.84 | $630.96 | $933.25 |
4 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 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $512.86 | Professional | 54 · Surgery only | $331.13 | $331.13 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $102.33 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $67.61 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $478.63 |
Where North Dakota sits
The same service costs 11.7 times more in New York than in North Carolina. 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.
North Dakota· 26th of 51
$631
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.