How much rates vary
Facilitymedian $1,549 · 10th to 90th $1,549 to $1,549Professionalmedian $1,549 · 10th to 90th $234 to $1,549
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 $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | 52 · Reduced service | $776.25 | $776.25 | $776.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | 53 · Discontinued | $309.03 | $309.03 | $309.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | 55 · Aftercare only | $234.42 | $234.42 | $234.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | 56 · Pre-op care only | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $154.88 |
BCBS Minnesota Setting Facility Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Facility | None | $1.00 | $1.00 | $1.00 |
BCBS Minnesota Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $363.08 | Professional | None | $151.36 | $223.87 | $363.08 |
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 |
|---|---|---|---|---|---|
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $223.87 Typical High $363.08 | Professional | 54 · Surgery only | $151.36 | $223.87 | $363.08 |