How much rates vary
Facilitymedian $8,128 · 10th to 90th $4,571 to $14,791Professionalmedian $65 · 10th to 90th $54 to $71
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 Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $676.08 | Professional | None | $630.96 | $630.96 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $8,128.31 Typical High $14,791.08 | Facility | None | $4,570.88 | $8,128.31 | $14,791.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $64.57 Typical High $70.79 | Professional | None | $53.70 | $64.57 | $70.79 |
4 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 $316.23 Median $316.23 Typical High $331.13 | Professional | 52 · Reduced service | $316.23 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | 53 · Discontinued | $125.89 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $67.61 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $67.61 |