How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,096 to $6,761Professionalmedian $661 · 10th to 90th $479 to $891
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 $616.60 Median $1,862.09 Typical High $3,715.35 | Facility | None | $616.60 | $1,862.09 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $630.96 Typical High $851.14 | Professional | None | $616.60 | $630.96 | $851.14 |
BCBS Louisiana Setting Facility Modifier None Typical Low $1,819.70 Median $2,818.38 Typical High $6,918.31 | Facility | None | $1,819.70 | $2,818.38 | $6,918.31 |
BCBS Louisiana Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $812.83 | Professional | None | $645.65 | $812.83 | $812.83 |
Christus Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $2,691.53 | Facility | None | $524.81 | $1,071.52 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $891.25 | Professional | None | $489.78 | $676.08 | $891.25 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,238.72 Typical High $8,128.31 | Facility | None | $1,047.13 | $2,238.72 | $8,128.31 |
United Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $891.25 | Professional | None | $436.52 | $537.03 | $891.25 |
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 $309.03 Median $316.23 Typical High $407.38 | Professional | 52 · Reduced service | $309.03 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $125.89 Typical High $162.18 | Professional | 53 · Discontinued | $123.03 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $478.63 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $478.63 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $95.50 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $63.10 Typical High $81.28 | Professional | 56 · Pre-op care only | $61.66 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $446.68 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $446.68 | $562.34 |
Where Louisiana sits
The same service costs 4.5 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $7,507MT $1,664
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.