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 $112.20 Median $154.88 Typical High $208.93 | Professional | None | $112.20 | $154.88 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
BCBS Louisiana Setting Facility Modifier None Typical Low $109.65 Median $169.82 Typical High $380.19 | Facility | None | $109.65 | $169.82 | $380.19 |
BCBS Louisiana Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $186.21 | Professional | None | $114.82 | $154.88 | $186.21 |
Christus Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $181.97 | Facility | None | $75.86 | $100.00 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $186.21 | Professional | None | $87.10 | $134.90 | $186.21 |
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 $95.50 Median $141.25 Typical High $213.80 | Professional | None | $95.50 | $141.25 | $213.80 |
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 $56.23 Median $77.62 Typical High $95.50 | Professional | 52 · Reduced service | $56.23 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.90 Typical High $38.02 | Professional | 53 · Discontinued | $22.39 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $114.82 Typical High $144.54 | Professional | 54 · Surgery only | $85.11 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.91 Typical High $28.84 | Professional | 55 · Aftercare only | $16.98 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $11.22 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $107.15 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $79.43 | $107.15 | $134.90 |
Where Louisiana sits
The same service costs 3.5 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· 43rd of 51
$141
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.