How much rates vary
Facilitymedian $977 · 10th to 90th $372 to $3,802Professionalmedian $5,248 · 10th to 90th $2,951 to $5,754
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 $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
BCBS Alabama Setting Professional Modifier 21 Typical Low $2,818.38 Median $3,890.45 Typical High $5,128.61 | Professional | 21 | $2,818.38 | $3,890.45 | $5,128.61 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $3,801.89 | Facility | None | $371.54 | $954.99 | $3,801.89 |
United Setting Professional Modifier None Typical Low $2,818.38 Median $3,467.37 Typical High $5,370.32 | Professional | None | $2,818.38 | $3,467.37 | $5,370.32 |
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 $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | 52 · Reduced service | $2,884.03 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | 54 · Surgery only | $4,365.16 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 56 · Pre-op care only | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $4,073.80 | $4,073.80 | $4,073.80 |