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 $691.83 Median $3,162.28 Typical High $5,623.41 | Facility | None | $691.83 | $3,162.28 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $691.83 | Professional | None | $575.44 | $630.96 | $691.83 |
BCBS Louisiana Setting Facility Modifier None Typical Low $6,165.95 Median $10,715.19 Typical High $22,908.68 | Facility | None | $6,165.95 | $10,715.19 | $22,908.68 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $23,988.33 | Facility | None | $524.81 | $1,174.90 | $23,988.33 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $7,762.47 Typical High $24,547.09 | Facility | None | $1,621.81 | $7,762.47 | $24,547.09 |
United Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $1,288.25 | Professional | None | $575.44 | $933.25 | $1,288.25 |
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 $223.87 Median $302.00 Typical High $316.23 | Professional | 52 · Reduced service | $223.87 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $120.23 Typical High $125.89 | Professional | 53 · Discontinued | $91.20 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $457.09 Typical High $478.63 | Professional | 54 · Surgery only | $338.84 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $91.20 Typical High $95.50 | Professional | 55 · Aftercare only | $67.61 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $60.26 Typical High $63.10 | Professional | 56 · Pre-op care only | $45.71 | $60.26 | $63.10 |
Where Louisiana sits
The same service costs 27.5 times more in Oklahoma 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· 5th of 51
$6,166
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.