How much rates vary
Facilitymedian $74 · 10th to 90th $32 to $129Professionalmedian $32 · 10th to 90th $20 to $36
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 Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $31.62 Median $74.13 Typical High $128.82 | Facility | None | $31.62 | $74.13 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $31.62 Typical High $36.31 | Professional | None | $19.95 | $31.62 | $36.31 |
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 $125.89 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $25.12 |