How much rates vary
Facilitymedian $933 · 10th to 90th $372 to $4,074Professionalmedian $6,310 · 10th to 90th $4,571 to $9,120
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 $3,235.94 Typical High $6,025.60 | Facility | None | $676.08 | $3,235.94 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $5,888.44 Median $7,413.10 Typical High $9,120.11 | Professional | None | $5,888.44 | $7,413.10 | $9,120.11 |
BCBS Louisiana Setting Professional Modifier None Typical Low $5,495.41 Median $6,918.31 Typical High $7,585.78 | Professional | None | $5,495.41 | $6,918.31 | $7,585.78 |
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 $354.81 Median $724.44 Typical High $4,073.80 | Facility | None | $354.81 | $724.44 | $4,073.80 |
United Setting Professional Modifier None Typical Low $4,073.80 Median $5,754.40 Typical High $9,549.93 | Professional | None | $4,073.80 | $5,754.40 | $9,549.93 |
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 $3,019.95 Median $3,715.35 Typical High $4,570.88 | Professional | 52 · Reduced service | $3,019.95 | $3,715.35 | $4,570.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,202.26 Median $1,479.11 Typical High $1,819.70 | Professional | 53 · Discontinued | $1,202.26 | $1,479.11 | $1,819.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,466.84 Median $5,623.41 Typical High $6,760.83 | Professional | 54 · Surgery only | $4,466.84 | $5,623.41 | $6,760.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $891.25 Median $1,122.02 Typical High $1,348.96 | Professional | 55 · Aftercare only | $891.25 | $1,122.02 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $602.56 Median $741.31 Typical High $912.01 | Professional | 56 · Pre-op care only | $602.56 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,168.69 Median $5,248.07 Typical High $6,309.57 | Professional | 78 · Unplanned return to OR | $4,168.69 | $5,248.07 | $6,309.57 |
Where Louisiana sits
The same service costs 8.4 times more in Wisconsin than in Texas. 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 $28,671TX $3,407
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.