How much rates vary
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 $501.19 Median $1,513.56 Typical High $3,548.13 | Facility | None | $501.19 | $1,513.56 | $3,548.13 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $501.19 | Professional | None | $416.87 | $436.52 | $501.19 |
BCBS Louisiana Setting Facility Modifier None Typical Low $1,122.02 Median $1,995.26 Typical High $6,025.60 | Facility | None | $1,122.02 | $1,995.26 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $1,995.26 | Facility | None | $524.81 | $1,071.52 | $1,995.26 |
United Setting Facility Modifier None Typical Low $446.68 Median $954.99 Typical High $3,630.78 | Facility | None | $446.68 | $954.99 | $3,630.78 |
United Setting Professional Modifier None Typical Low $416.87 Median $676.08 Typical High $933.25 | Professional | None | $416.87 | $676.08 | $933.25 |
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 $194.98 Median $218.78 Typical High $229.09 | Professional | 52 · Reduced service | $194.98 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $87.10 Typical High $91.20 | Professional | 53 · Discontinued | $77.62 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $323.59 Typical High $338.84 | Professional | 54 · Surgery only | $288.40 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $66.07 Typical High $69.18 | Professional | 55 · Aftercare only | $57.54 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $43.65 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.90 | $43.65 | $45.71 |
Where Louisiana sits
The same service costs 8.1 times more in Texas than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Louisiana· 10th of 51
$1,148
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.