How much rates vary
Professionalmedian $79 · 10th to 90th $1 to $79
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 $0.81 Median $0.87 Typical High $0.87 | Professional | None | $0.81 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.41 Median $0.44 Typical High $0.44 | Professional | 52 · Reduced service | $0.41 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.13 Typical High $0.13 | Professional | 55 · Aftercare only | $0.12 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.08 | $0.09 | $0.09 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
1 more rate 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 |
|---|---|---|---|---|---|
MountainHealth Co-op Setting Facility Modifier CSTM-00 Typical Low $208.93 Median $208.93 Typical High $338.84 | Facility | CSTM-00 | $208.93 | $208.93 | $338.84 |