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 $112.20 Median $1,258.93 Typical High $3,467.37 | Facility | None | $112.20 | $1,258.93 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $144.54 | Professional | None | $69.18 | $104.71 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $154.88 | Professional | None | $85.11 | $102.33 | $154.88 |
BCBS Louisiana Setting Facility Modifier None Typical Low $125.89 Median $275.42 Typical High $416.87 | Facility | None | $125.89 | $275.42 | $416.87 |
BCBS Louisiana Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $123.03 | Professional | None | $74.13 | $104.71 | $123.03 |
Christus Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
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 $56.23 Median $89.13 Typical High $128.82 | Professional | None | $56.23 | $89.13 | $128.82 |
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 $58.88 Median $93.33 Typical High $138.04 | Professional | None | $58.88 | $93.33 | $138.04 |
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 $34.67 Median $48.98 Typical High $64.57 | Professional | 52 · Reduced service | $34.67 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $19.50 Typical High $25.70 | Professional | 53 · Discontinued | $14.13 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $74.13 Typical High $97.72 | Professional | 54 · Surgery only | $52.48 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $14.79 Typical High $19.50 | Professional | 55 · Aftercare only | $10.47 | $14.79 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $9.77 Typical High $12.88 | Professional | 56 · Pre-op care only | $6.92 | $9.77 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $69.18 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $48.98 | $69.18 | $91.20 |
Where Louisiana sits
The same service costs 3.9 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· 41st of 51
$102
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.