How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,202 to $7,244Professionalmedian $1,072 · 10th to 90th $794 to $1,445
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 $676.08 Median $1,862.09 Typical High $3,715.35 | Facility | None | $676.08 | $1,862.09 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,071.52 | $1,445.44 |
BCBS Louisiana Setting Facility Modifier None Typical Low $1,819.70 Median $2,818.38 Typical High $7,244.36 | Facility | None | $1,819.70 | $2,818.38 | $7,244.36 |
BCBS Louisiana Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,380.38 | $1,380.38 |
Christus Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
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 $741.31 Median $933.25 Typical High $1,513.56 | Professional | None | $741.31 | $933.25 | $1,513.56 |
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 $512.86 Median $537.03 Typical High $676.08 | Professional | 52 · Reduced service | $512.86 | $537.03 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $269.15 | Professional | 53 · Discontinued | $208.93 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $1,023.29 | Professional | 54 · Surgery only | $776.25 | $794.33 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $204.17 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $107.15 Typical High $134.90 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $954.99 |
Where Louisiana sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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
WI $8,857KS $2,587
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.