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 $676.08 Median $2,691.53 Typical High $3,890.45 | Facility | None | $676.08 | $2,691.53 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,445.44 | $1,584.89 |
BCBS Louisiana Setting Facility Modifier None Typical Low $3,981.07 Median $4,786.30 Typical High $11,220.18 | Facility | None | $3,981.07 | $4,786.30 | $11,220.18 |
BCBS Louisiana Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,412.54 | $1,862.09 | $1,862.09 |
Christus Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $5,011.87 | Facility | None | $524.81 | $1,071.52 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,412.54 Typical High $1,778.28 | Professional | None | $758.58 | $1,412.54 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $3,801.89 Typical High $12,589.25 | Facility | None | $1,348.96 | $3,801.89 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,621.81 | $2,238.72 |
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 $602.56 Median $724.44 Typical High $794.33 | Professional | 52 · Reduced service | $602.56 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $288.40 Typical High $316.23 | Professional | 53 · Discontinued | $239.88 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,071.52 Typical High $1,174.90 | Professional | 54 · Surgery only | $912.01 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $213.80 Typical High $234.42 | Professional | 55 · Aftercare only | $181.97 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $144.54 Typical High $158.49 | Professional | 56 · Pre-op care only | $120.23 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,000.00 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $851.14 | $1,000.00 | $1,096.48 |
Where Louisiana sits
The same service costs 5.1 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.
Louisiana· 10th of 51
$2,344
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.