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 $117.49 Median $162.18 Typical High $223.87 | Professional | None | $117.49 | $162.18 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $120.23 Median $165.96 Typical High $199.53 | Professional | None | $120.23 | $165.96 | $199.53 |
Christus Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
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 $91.20 Median $144.54 Typical High $199.53 | Professional | None | $91.20 | $144.54 | $199.53 |
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 $100.00 Median $151.36 Typical High $229.09 | Professional | None | $100.00 | $151.36 | $229.09 |
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 $60.26 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $60.26 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $32.36 Typical High $41.69 | Professional | 53 · Discontinued | $23.99 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $120.23 Typical High $154.88 | Professional | 54 · Surgery only | $89.13 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $23.99 Typical High $30.90 | Professional | 55 · Aftercare only | $17.78 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $16.22 Typical High $20.89 | Professional | 56 · Pre-op care only | $12.02 | $16.22 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $112.20 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $83.18 | $112.20 | $144.54 |
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· 40th of 51
$158
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.