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 $398.11 Median $2,691.53 Typical High $3,890.45 | Facility | None | $398.11 | $2,691.53 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $102.33 Typical High $125.89 | Professional | None | $100.00 | $102.33 | $125.89 |
BCBS Louisiana Setting Facility Modifier None Typical Low $2,137.96 Median $3,715.35 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,715.35 | $5,370.32 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,951.21 Typical High $6,309.57 | Facility | None | $831.76 | $2,951.21 | $6,309.57 |
United Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $234.42 | Professional | None | $104.71 | $162.18 | $234.42 |
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 $50.12 Median $51.29 Typical High $53.70 | Professional | 52 · Reduced service | $50.12 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.42 Typical High $21.38 | Professional | 53 · Discontinued | $19.95 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $77.62 Typical High $81.28 | Professional | 54 · Surgery only | $75.86 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $16.22 | Professional | 55 · Aftercare only | $15.14 | $15.49 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.00 | $10.23 | $10.72 |
Where Louisiana sits
The same service costs 51.3 times more in Oklahoma than in Kentucky. 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· 6th of 51
$2,692
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.