How much rates vary
Facilitymedian $2,344 · 10th to 90th $832 to $5,129Professionalmedian $245 · 10th to 90th $178 to $347
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 $389.05 Median $1,513.56 Typical High $3,548.13 | Facility | None | $389.05 | $1,513.56 | $3,548.13 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $331.13 | Professional | None | $190.55 | $257.04 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
BCBS Louisiana Setting Facility Modifier None Typical Low $1,230.27 Median $2,398.83 Typical High $5,623.41 | Facility | None | $1,230.27 | $2,398.83 | $5,623.41 |
BCBS Louisiana Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $288.40 | Professional | None | $199.53 | $245.47 | $288.40 |
Christus Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $831.76 Typical High $2,187.76 | Facility | None | $501.19 | $831.76 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $426.58 | Professional | None | $181.97 | $257.04 | $426.58 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,548.82 Typical High $5,888.44 | Facility | None | $851.14 | $1,548.82 | $5,888.44 |
United Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $354.81 | Professional | None | $154.88 | $223.87 | $354.81 |
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 $95.50 Median $128.82 Typical High $154.88 | Professional | 52 · Reduced service | $95.50 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $51.29 Typical High $61.66 | Professional | 53 · Discontinued | $38.90 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $194.98 Typical High $229.09 | Professional | 54 · Surgery only | $144.54 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $38.90 Typical High $45.71 | Professional | 55 · Aftercare only | $28.84 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $25.70 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.50 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $181.97 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $134.90 | $181.97 | $213.80 |
Where Louisiana sits
The same service costs 9.3 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $5,912MT $637
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.