How much rates vary
Facilitymedian $525 · 10th to 90th $282 to $2,455Professionalmedian $5,129 · 10th to 90th $3,311 to $8,913
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 $6,309.57 | Facility | None | $1,071.52 | $1,862.09 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $6,309.57 Typical High $6,309.57 | Professional | None | $4,570.88 | $6,309.57 | $6,309.57 |
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 $3,235.94 Median $4,570.88 Typical High $9,120.11 | Professional | None | $3,235.94 | $4,570.88 | $9,120.11 |
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 $2,344.23 Median $3,162.28 Typical High $3,162.28 | Professional | 52 · Reduced service | $2,344.23 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | 53 · Discontinued | $933.25 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,548.13 Median $4,677.35 Typical High $4,677.35 | Professional | 54 · Surgery only | $3,548.13 | $4,677.35 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $707.95 Median $954.99 Typical High $954.99 | Professional | 55 · Aftercare only | $707.95 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $630.96 Typical High $630.96 | Professional | 56 · Pre-op care only | $467.74 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,311.31 Median $4,365.16 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $3,311.31 | $4,365.16 | $4,365.16 |