How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,318 to $8,710Professionalmedian $724 · 10th to 90th $537 to $1,000
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 $645.65 Median $2,398.83 Typical High $4,168.69 | Facility | None | $645.65 | $2,398.83 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,000.00 | Professional | None | $616.60 | $741.31 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $616.60 | Professional | None | $588.84 | $602.56 | $616.60 |
BCBS Louisiana Setting Facility Modifier None Typical Low $1,819.70 Median $2,818.38 Typical High $9,549.93 | Facility | None | $1,819.70 | $2,818.38 | $9,549.93 |
BCBS Louisiana Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $933.25 | Professional | None | $724.44 | $933.25 | $933.25 |
Christus Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,348.96 Typical High $2,884.03 | Facility | None | $645.65 | $1,348.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,000.00 | Professional | None | $562.34 | $758.58 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $3,630.78 Typical High $11,481.54 | Facility | None | $1,348.96 | $3,630.78 | $11,481.54 |
United Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,023.29 | Professional | None | $478.63 | $616.60 | $1,023.29 |
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 $354.81 Median $363.08 Typical High $467.74 | Professional | 52 · Reduced service | $354.81 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $147.91 Typical High $186.21 | Professional | 53 · Discontinued | $141.25 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $549.54 Typical High $707.95 | Professional | 54 · Surgery only | $537.03 | $549.54 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $109.65 Typical High $141.25 | Professional | 55 · Aftercare only | $107.15 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $74.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $70.79 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $512.86 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $501.19 | $512.86 | $660.69 |
Where Louisiana sits
The same service costs 4.7 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 $8,820MT $1,888
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.