How much rates vary
Facilitymedian $1,549 · 10th to 90th $871 to $4,898Professionalmedian $813 · 10th to 90th $589 to $1,023
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 $676.08 Median $1,862.09 Typical High $3,715.35 | Facility | None | $676.08 | $1,862.09 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,096.48 | Professional | None | $724.44 | $891.25 | $1,096.48 |
Ambetter Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
BCBS Louisiana Setting Facility Modifier None Typical Low $1,000.00 Median $1,698.24 Typical High $4,897.79 | Facility | None | $1,000.00 | $1,698.24 | $4,897.79 |
BCBS Louisiana Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $933.25 | Professional | None | $741.31 | $812.83 | $933.25 |
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 $524.81 Median $954.99 Typical High $1,995.26 | Facility | None | $524.81 | $954.99 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,000.00 | Professional | None | $562.34 | $707.95 | $1,000.00 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,548.82 Typical High $5,754.40 | Facility | None | $831.76 | $1,548.82 | $5,754.40 |
United Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,174.90 | Professional | None | $575.44 | $776.25 | $1,174.90 |
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 $363.08 Median $436.52 Typical High $501.19 | Professional | 52 · Reduced service | $363.08 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $173.78 Typical High $199.53 | Professional | 53 · Discontinued | $144.54 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $549.54 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $131.83 Typical High $151.36 | Professional | 55 · Aftercare only | $109.65 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $72.44 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $512.86 | $616.60 | $707.95 |
Where Louisiana sits
The same service costs 3.1 times more in Alaska than in Maryland. 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
AK $5,990MD $1,938
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.