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 $109.65 Median $2,511.89 Typical High $3,890.45 | Facility | None | $109.65 | $2,511.89 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $100.00 Typical High $138.04 | Professional | None | $57.54 | $100.00 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $104.71 | Professional | None | $89.13 | $89.13 | $104.71 |
BCBS Louisiana Setting Facility Modifier None Typical Low $29.51 Median $154.88 Typical High $426.58 | Facility | None | $29.51 | $154.88 | $426.58 |
BCBS Louisiana Setting Professional Modifier None Typical Low $57.54 Median $107.15 Typical High $128.82 | Professional | None | $57.54 | $107.15 | $128.82 |
Christus Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $151.36 | Facility | None | $75.86 | $100.00 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $87.10 Typical High $125.89 | Professional | None | $42.66 | $87.10 | $125.89 |
United Setting Facility Modifier None Typical Low $91.20 Median $338.84 Typical High $1,202.26 | Facility | None | $91.20 | $338.84 | $1,202.26 |
United Setting Professional Modifier None Typical Low $50.12 Median $89.13 Typical High $134.90 | Professional | None | $50.12 | $89.13 | $134.90 |
6 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 $28.84 Median $38.02 Typical High $64.57 | Professional | 52 · Reduced service | $28.84 | $38.02 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $15.14 Typical High $25.70 | Professional | 53 · Discontinued | $11.48 | $15.14 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $57.54 Typical High $95.50 | Professional | 54 · Surgery only | $43.65 | $57.54 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $11.48 Typical High $19.05 | Professional | 55 · Aftercare only | $8.71 | $11.48 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.59 Typical High $12.88 | Professional | 56 · Pre-op care only | $5.75 | $7.59 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $40.74 Median $53.70 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $40.74 | $53.70 | $89.13 |
Where Louisiana sits
The same service costs 3.2 times more in Alaska 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· 35th of 51
$100
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.