How much rates vary
Facilitymedian $2,818 · 10th to 90th $2,818 to $2,818Professionalmedian $234 · 10th to 90th $195 to $269
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 $199.53 Median $234.42 Typical High $234.42 | Professional | None | $199.53 | $234.42 | $234.42 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
BCBS Alabama Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $269.15 | Professional | None | $194.98 | $263.03 | $269.15 |
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 $100.00 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $100.00 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $39.81 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $147.91 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $30.20 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.95 | $23.44 | $23.44 |