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 $181.97 Median $2,187.76 Typical High $3,890.45 | Facility | None | $181.97 | $2,187.76 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $281.84 | Professional | None | $158.49 | $199.53 | $281.84 |
BCBS Louisiana Setting Facility Modifier None Typical Low $123.03 Median $707.95 Typical High $1,905.46 | Facility | None | $123.03 | $707.95 | $1,905.46 |
BCBS Louisiana Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $295.12 | Professional | None | $147.91 | $204.17 | $295.12 |
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 $117.49 Median $190.55 Typical High $338.84 | Professional | None | $117.49 | $190.55 | $338.84 |
United Setting Facility Modifier None Typical Low $446.68 Median $954.99 Typical High $2,951.21 | Facility | None | $446.68 | $954.99 | $2,951.21 |
United Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $331.13 | Professional | None | $117.49 | $199.53 | $331.13 |
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 $79.43 Median $91.20 Typical High $138.04 | Professional | 52 · Reduced service | $79.43 | $91.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $36.31 Typical High $56.23 | Professional | 53 · Discontinued | $32.36 | $36.31 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $134.90 Typical High $208.93 | Professional | 54 · Surgery only | $120.23 | $134.90 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $27.54 Typical High $41.69 | Professional | 55 · Aftercare only | $23.99 | $27.54 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.20 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.85 | $18.20 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $125.89 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $112.20 | $125.89 | $194.98 |
Where Louisiana sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 25th of 51
$219
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.