How much rates vary
Facilitymedian $977 · 10th to 90th $372 to $3,802Professionalmedian $6,607 · 10th to 90th $3,715 to $7,943
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 $7,943.28 Median $7,943.28 Typical High $7,943.28 | Professional | None | $7,943.28 | $7,943.28 | $7,943.28 |
BCBS Alabama Setting Professional Modifier 21 Typical Low $3,467.37 Median $4,786.30 Typical High $7,079.46 | Professional | 21 | $3,467.37 | $4,786.30 | $7,079.46 |
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 $3,548.13 Median $4,786.30 Typical High $7,244.36 | Professional | None | $3,548.13 | $4,786.30 | $7,244.36 |
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 $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | 52 · Reduced service | $3,981.07 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 53 · Discontinued | $1,584.89 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | 54 · Surgery only | $5,888.44 | $5,888.44 | $5,888.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 55 · Aftercare only | $1,174.90 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 56 · Pre-op care only | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | 78 · Unplanned return to OR | $5,495.41 | $5,495.41 | $5,495.41 |