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 $70.79 Median $1,258.93 Typical High $3,467.37 | Facility | None | $70.79 | $1,258.93 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $93.33 | Professional | None | $56.23 | $69.18 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $100.00 | Professional | None | $54.95 | $61.66 | $100.00 |
BCBS Louisiana Setting Facility Modifier None Typical Low $100.00 Median $186.21 Typical High $426.58 | Facility | None | $100.00 | $186.21 | $426.58 |
BCBS Louisiana Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $74.13 | Professional | None | $60.26 | $63.10 | $74.13 |
Christus Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
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 $44.67 Median $57.54 Typical High $87.10 | Professional | None | $44.67 | $57.54 | $87.10 |
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 $47.86 Median $61.66 Typical High $93.33 | Professional | None | $47.86 | $61.66 | $93.33 |
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 $28.18 Median $33.11 Typical High $38.90 | Professional | 52 · Reduced service | $28.18 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $13.18 Typical High $15.85 | Professional | 53 · Discontinued | $11.22 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $50.12 Typical High $58.88 | Professional | 54 · Surgery only | $41.69 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.00 Typical High $11.75 | Professional | 55 · Aftercare only | $8.51 | $10.00 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.61 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.62 | $6.61 | $7.94 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $46.77 Typical High $54.95 | Professional | 78 · Unplanned return to OR | $38.90 | $46.77 | $54.95 |
Where Louisiana sits
The same service costs 4.2 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· 35th of 51
$69.18
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.