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 $288.40 Median $1,288.25 Typical High $3,467.37 | Facility | None | $288.40 | $1,288.25 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $123.03 | Professional | None | $72.44 | $97.72 | $123.03 |
BCBS Louisiana Setting Facility Modifier None Typical Low $125.89 Median $338.84 Typical High $512.86 | Facility | None | $125.89 | $338.84 | $512.86 |
BCBS Louisiana Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $109.65 | Professional | None | $77.62 | $93.33 | $109.65 |
Christus Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
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 $57.54 Median $81.28 Typical High $120.23 | Professional | None | $57.54 | $81.28 | $120.23 |
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 $63.10 Median $85.11 Typical High $131.83 | Professional | None | $63.10 | $85.11 | $131.83 |
7 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 $37.15 Median $48.98 Typical High $56.23 | Professional | 52 · Reduced service | $37.15 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $19.50 Typical High $22.91 | Professional | 53 · Discontinued | $14.79 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $74.13 Typical High $85.11 | Professional | 54 · Surgery only | $56.23 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $14.79 Typical High $16.98 | Professional | 55 · Aftercare only | $11.22 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.77 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.41 | $9.77 | $11.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $69.18 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $52.48 | $69.18 | $79.43 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 59 · Distinct service | $100.00 | $100.00 | $100.00 |
Where Louisiana sits
The same service costs 3.8 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
$95.50
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.