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 $1,096.48 Typical High $3,467.37 | Facility | None | $123.03 | $1,096.48 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $194.98 | Professional | None | $107.15 | $151.36 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $89.13 | Professional | None | $79.43 | $85.11 | $89.13 |
BCBS Louisiana Setting Facility Modifier None Typical Low $112.20 Median $331.13 Typical High $1,000.00 | Facility | None | $112.20 | $331.13 | $1,000.00 |
BCBS Louisiana Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $169.82 | Professional | None | $114.82 | $141.25 | $169.82 |
Christus Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $102.33 Typical High $190.55 | Facility | None | $75.86 | $102.33 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $245.47 | Professional | None | $104.71 | $147.91 | $245.47 |
United Setting Facility Modifier None Typical Low $91.20 Median $407.38 Typical High $1,202.26 | Facility | None | $91.20 | $407.38 | $1,202.26 |
United Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $204.17 | Professional | None | $89.13 | $131.83 | $204.17 |
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 $53.70 Median $75.86 Typical High $89.13 | Professional | 52 · Reduced service | $53.70 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $30.20 Typical High $35.48 | Professional | 53 · Discontinued | $21.88 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $114.82 Typical High $131.83 | Professional | 54 · Surgery only | $81.28 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $22.91 Typical High $26.92 | Professional | 55 · Aftercare only | $16.22 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.14 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.96 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $107.15 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $75.86 | $107.15 | $123.03 |
Where Louisiana sits
The same service costs 4.1 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· 27th of 51
$155
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.