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 $125.89 Median $173.78 Typical High $229.09 | Professional | None | $125.89 | $173.78 | $229.09 |
BCBS Louisiana Setting Facility Modifier None Typical Low $123.03 Median $275.42 Typical High $676.08 | Facility | None | $123.03 | $275.42 | $676.08 |
BCBS Louisiana Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $199.53 | Professional | None | $128.82 | $165.96 | $199.53 |
Christus Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $186.21 | Facility | None | $75.86 | $100.00 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $213.80 | Professional | None | $97.72 | $144.54 | $213.80 |
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 $107.15 Median $154.88 Typical High $245.47 | Professional | None | $107.15 | $154.88 | $245.47 |
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 $63.10 Median $87.10 Typical High $104.71 | Professional | 52 · Reduced service | $63.10 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $34.67 Typical High $41.69 | Professional | 53 · Discontinued | $25.70 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $128.82 Typical High $158.49 | Professional | 54 · Surgery only | $95.50 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $25.70 Typical High $31.62 | Professional | 55 · Aftercare only | $19.05 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $17.38 Typical High $20.89 | Professional | 56 · Pre-op care only | $12.88 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $120.23 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $89.13 | $120.23 | $147.91 |
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· 42nd 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.