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 $123.03 Median $676.08 Typical High $3,467.37 | Facility | None | $123.03 | $676.08 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $165.96 | Professional | None | $104.71 | $128.82 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $245.47 | Professional | None | $107.15 | $158.49 | $245.47 |
BCBS Louisiana Setting Facility Modifier None Typical Low $87.10 Median $181.97 Typical High $537.03 | Facility | None | $87.10 | $181.97 | $537.03 |
BCBS Louisiana Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $141.25 | Professional | None | $117.49 | $120.23 | $141.25 |
Christus Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
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 $107.15 Median $128.82 Typical High $208.93 | Professional | None | $107.15 | $128.82 | $208.93 |
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 $83.18 Median $112.20 Typical High $165.96 | Professional | None | $83.18 | $112.20 | $165.96 |
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 $52.48 Median $61.66 Typical High $77.62 | Professional | 52 · Reduced service | $52.48 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.12 Typical High $30.90 | Professional | 53 · Discontinued | $21.38 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $79.43 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $18.62 Typical High $22.91 | Professional | 55 · Aftercare only | $15.85 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.30 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.72 | $12.30 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $87.10 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $74.13 | $87.10 | $107.15 |
Where Louisiana sits
The same service costs 4.4 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· 28th of 51
$132
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.