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 $398.11 Median $1,288.25 Typical High $3,467.37 | Facility | None | $398.11 | $1,288.25 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $67.61 Typical High $77.62 | Professional | None | $56.23 | $67.61 | $77.62 |
BCBS Louisiana Setting Facility Modifier None Typical Low $16.60 Median $74.13 Typical High $165.96 | Facility | None | $16.60 | $74.13 | $165.96 |
BCBS Louisiana Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $87.10 | Professional | None | $66.07 | $79.43 | $87.10 |
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 $75.86 Median $100.00 Typical High $151.36 | Facility | None | $75.86 | $100.00 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $66.07 Typical High $95.50 | Professional | None | $47.86 | $66.07 | $95.50 |
United Setting Facility Modifier None Typical Low $91.20 Median $338.84 Typical High $1,202.26 | Facility | None | $91.20 | $338.84 | $1,202.26 |
United Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $100.00 | Professional | None | $47.86 | $72.44 | $100.00 |
5 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 $28.18 Median $33.88 Typical High $37.15 | Professional | 52 · Reduced service | $28.18 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $13.49 Typical High $14.79 | Professional | 53 · Discontinued | $11.22 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $51.29 Typical High $54.95 | Professional | 54 · Surgery only | $42.66 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.23 Typical High $10.96 | Professional | 55 · Aftercare only | $8.51 | $10.23 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.76 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.62 | $6.76 | $7.41 |
Where Louisiana sits
The same service costs 6.5 times more in Tennessee than in New York. 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· 22nd of 51
$87.10
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.