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 $213.80 Median $1,258.93 Typical High $3,467.37 | Facility | None | $213.80 | $1,258.93 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $251.19 | Professional | None | $169.82 | $199.53 | $251.19 |
BCBS Louisiana Setting Facility Modifier None Typical Low $131.83 Median $229.09 Typical High $870.96 | Facility | None | $131.83 | $229.09 | $870.96 |
BCBS Louisiana Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $263.03 | Professional | None | $181.97 | $234.42 | $263.03 |
Christus Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $107.15 Typical High $199.53 | Facility | None | $75.86 | $107.15 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $281.84 | Professional | None | $158.49 | $199.53 | $281.84 |
United Setting Facility Modifier None Typical Low $91.20 Median $363.08 Typical High $1,202.26 | Facility | None | $91.20 | $363.08 | $1,202.26 |
United Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $263.03 | Professional | None | $125.89 | $158.49 | $263.03 |
7 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 $85.11 Median $100.00 Typical High $120.23 | Professional | 52 · Reduced service | $85.11 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $39.81 Typical High $48.98 | Professional | 53 · Discontinued | $34.67 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $128.82 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.20 Typical High $36.31 | Professional | 55 · Aftercare only | $25.70 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.95 Typical High $23.99 | Professional | 56 · Pre-op care only | $16.98 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $120.23 | $141.25 | $169.82 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 51 · Multiple procedures | $87.10 | $87.10 | $87.10 |
Where Louisiana sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 21st of 51
$209
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.