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 $616.60 Median $1,862.09 Typical High $3,801.89 | Facility | None | $616.60 | $1,862.09 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $645.65 | Professional | None | $562.34 | $588.84 | $645.65 |
BCBS Louisiana Setting Facility Modifier None Typical Low $2,398.83 Median $3,890.45 Typical High $13,182.57 | Facility | None | $2,398.83 | $3,890.45 | $13,182.57 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $3,311.31 | Facility | None | $524.81 | $1,174.90 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,238.72 Typical High $8,317.64 | Facility | None | $1,047.13 | $2,238.72 | $8,317.64 |
United Setting Professional Modifier None Typical Low $549.54 Median $870.96 Typical High $1,202.26 | Professional | None | $549.54 | $870.96 | $1,202.26 |
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 $275.42 Median $281.84 Typical High $295.12 | Professional | 52 · Reduced service | $275.42 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $117.49 | Professional | 53 · Discontinued | $109.65 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $426.58 Typical High $446.68 | Professional | 54 · Surgery only | $407.38 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $81.28 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $58.88 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $58.88 |
Where Louisiana sits
The same service costs 10.2 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· 4th of 51
$2,399
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.