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 $724.44 Median $2,511.89 Typical High $3,890.45 | Facility | None | $724.44 | $2,511.89 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $933.25 | Professional | None | $794.33 | $851.14 | $933.25 |
BCBS Louisiana Setting Facility Modifier None Typical Low $5,248.07 Median $8,317.64 Typical High $17,378.01 | Facility | None | $5,248.07 | $8,317.64 | $17,378.01 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $11,481.54 | Facility | None | $524.81 | $1,174.90 | $11,481.54 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,621.81 | $7,762.47 | $17,378.01 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,258.93 Typical High $1,737.80 | Professional | None | $776.25 | $1,258.93 | $1,737.80 |
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 $398.11 Median $407.38 Typical High $426.58 | Professional | 52 · Reduced service | $398.11 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $169.82 | Professional | 53 · Discontinued | $158.49 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $645.65 | Professional | 54 · Surgery only | $588.84 | $616.60 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $128.82 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $81.28 Typical High $85.11 | Professional | 56 · Pre-op care only | $79.43 | $81.28 | $85.11 |
Where Louisiana sits
The same service costs 16.2 times more in Arkansas 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· 4th of 51
$5,248
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.