How much rates vary
Facilitymedian $5,754 · 10th to 90th $4,365 to $8,511Professionalmedian $275 · 10th to 90th $204 to $501
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 $194.98 Median $457.09 Typical High $457.09 | Professional | None | $194.98 | $457.09 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $501.19 | Professional | None | $204.17 | $275.42 | $501.19 |
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 $97.72 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $97.72 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $38.90 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $144.54 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $29.51 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $19.50 | $45.71 | $45.71 |