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 $67.61 Median $1,096.48 Typical High $3,467.37 | Facility | None | $67.61 | $1,096.48 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $66.07 Typical High $87.10 | Professional | None | $47.86 | $66.07 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $93.33 Typical High $93.33 | Professional | None | $38.02 | $93.33 | $93.33 |
BCBS Setting Facility Modifier None Typical Low $33.11 Median $97.72 Typical High $575.44 | Facility | None | $33.11 | $97.72 | $575.44 |
BCBS Setting Professional Modifier None Typical Low $46.77 Median $60.26 Typical High $83.18 | Professional | None | $46.77 | $60.26 | $83.18 |
Christus Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $316.23 Typical High $676.08 | Facility | None | $30.90 | $316.23 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $89.13 | Professional | None | $39.81 | $60.26 | $89.13 |
United Setting Facility Modifier None Typical Low $91.20 Median $380.19 Typical High $1,202.26 | Facility | None | $91.20 | $380.19 | $1,202.26 |
United Setting Professional Modifier None Typical Low $35.48 Median $53.70 Typical High $85.11 | Professional | None | $35.48 | $53.70 | $85.11 |
5 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 $23.99 Median $33.88 Typical High $41.69 | Professional | 52 · Reduced service | $23.99 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $13.49 Typical High $16.98 | Professional | 53 · Discontinued | $9.55 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $50.12 Typical High $63.10 | Professional | 54 · Surgery only | $36.31 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.00 Typical High $12.59 | Professional | 55 · Aftercare only | $7.24 | $10.00 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.76 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.79 | $6.76 | $8.32 |
Where Louisiana sits
The same service costs 4.2 times more in Alaska than in New York. 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· 23rd of 51
$63.10
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.