How much rates vary
Facilitymedian $2,138 · 10th to 90th $457 to $5,495Professionalmedian $3,548 · 10th to 90th $3,548 to $3,548
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 $5,495.41 Typical High $12,022.64 | Facility | None | $776.25 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $2,691.53 | Facility | None | $446.68 | $1,047.13 | $2,691.53 |
5 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 $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,630.27 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $354.81 |