How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,514 to $12,023Professionalmedian $1,380 · 10th to 90th $1,023 to $1,862
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 $851.14 Median $2,691.53 Typical High $11,748.98 | Facility | None | $851.14 | $2,691.53 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,202.26 | $1,380.38 | $1,905.46 |
Ambetter Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,122.02 | Professional | None | $1,071.52 | $1,096.48 | $1,122.02 |
BCBS Louisiana Setting Facility Modifier None Typical Low $4,073.80 Median $5,754.40 Typical High $12,882.50 | Facility | None | $4,073.80 | $5,754.40 | $12,882.50 |
BCBS Louisiana Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,737.80 | $1,737.80 |
Christus Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Facility | None | $5,888.44 | $5,888.44 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $6,309.57 | Facility | None | $707.95 | $1,905.46 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,412.54 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $3,890.45 Typical High $12,589.25 | Facility | None | $1,348.96 | $3,890.45 | $12,589.25 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,949.84 | Professional | None | $954.99 | $1,174.90 | $1,949.84 |
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 $676.08 Median $691.83 Typical High $891.25 | Professional | 52 · Reduced service | $676.08 | $691.83 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $354.81 | Professional | 53 · Discontinued | $269.15 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,047.13 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,000.00 | $1,047.13 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $208.93 Typical High $269.15 | Professional | 55 · Aftercare only | $199.53 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $138.04 Typical High $177.83 | Professional | 56 · Pre-op care only | $134.90 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $977.24 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $933.25 | $977.24 | $1,230.27 |
Where Louisiana sits
The same service costs 4.2 times more in Colorado 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
CO $14,362MT $3,396
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.