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 $204.17 Median $977.24 Typical High $3,467.37 | Facility | None | $204.17 | $977.24 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $346.74 | Professional | None | $177.83 | $251.19 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $346.74 Typical High $346.74 | Professional | None | $169.82 | $346.74 | $346.74 |
BCBS Setting Facility Modifier None Typical Low $208.93 Median $331.13 Typical High $1,047.13 | Facility | None | $208.93 | $331.13 | $1,047.13 |
BCBS Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $309.03 | Professional | None | $186.21 | $257.04 | $309.03 |
Christus Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $151.36 Typical High $316.23 | Facility | None | $75.86 | $151.36 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $457.09 | Professional | None | $169.82 | $275.42 | $457.09 |
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 $147.91 Median $234.42 Typical High $346.74 | Professional | None | $147.91 | $234.42 | $346.74 |
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 $91.20 Median $123.03 Typical High $158.49 | Professional | 52 · Reduced service | $91.20 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $48.98 Typical High $64.57 | Professional | 53 · Discontinued | $36.31 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $181.97 Typical High $239.88 | Professional | 54 · Surgery only | $134.90 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $36.31 Typical High $47.86 | Professional | 55 · Aftercare only | $26.92 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $24.55 Typical High $31.62 | Professional | 56 · Pre-op care only | $18.20 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $169.82 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $125.89 | $169.82 | $223.87 |
Where Louisiana sits
The same service costs 3.4 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· 36th of 51
$251
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.