How much rates vary
Facilitymedian $525 · 10th to 90th $282 to $2,455Professionalmedian $3,981 · 10th to 90th $2,818 to $6,607
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 $1,071.52 Median $1,862.09 Typical High $4,677.35 | Facility | None | $1,071.52 | $1,862.09 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $4,677.35 Typical High $4,677.35 | Professional | None | $3,388.44 | $4,677.35 | $4,677.35 |
United Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $1,995.26 | Facility | None | $281.84 | $457.09 | $1,995.26 |
United Setting Professional Modifier None Typical Low $2,691.53 Median $3,548.13 Typical High $6,760.83 | Professional | None | $2,691.53 | $3,548.13 | $6,760.83 |
6 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 $1,905.46 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,905.46 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $933.25 Typical High $933.25 | Professional | 53 · Discontinued | $758.58 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $3,467.37 Typical High $3,467.37 | Professional | 54 · Surgery only | $2,884.03 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | 55 · Aftercare only | $575.44 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $467.74 Typical High $467.74 | Professional | 56 · Pre-op care only | $380.19 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $3,235.94 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,691.53 | $3,235.94 | $3,235.94 |