How much rates vary
Facilitymedian $5,754 · 10th to 90th $4,365 to $8,511Professionalmedian $229 · 10th to 90th $170 to $389
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $389.05 Typical High $389.05 | Professional | None | $162.18 | $389.05 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $389.05 | Professional | None | $169.82 | $229.09 | $389.05 |
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 $81.28 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $81.28 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $32.36 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $123.03 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $24.55 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $16.22 | $38.90 | $38.90 |