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 $128.82 Median $1,258.93 Typical High $3,467.37 | Facility | None | $128.82 | $1,258.93 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $97.72 Typical High $138.04 | Professional | None | $40.74 | $97.72 | $138.04 |
BCBS Louisiana Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $954.99 | Facility | None | $100.00 | $363.08 | $954.99 |
BCBS Louisiana Setting Professional Modifier None Typical Low $38.90 Median $61.66 Typical High $151.36 | Professional | None | $38.90 | $61.66 | $151.36 |
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 $251.19 | Facility | None | $75.86 | $100.00 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $69.18 Typical High $169.82 | Professional | None | $29.51 | $69.18 | $169.82 |
United Setting Facility Modifier None Typical Low $91.20 Median $407.38 Typical High $1,202.26 | Facility | None | $91.20 | $407.38 | $1,202.26 |
United Setting Professional Modifier None Typical Low $30.90 Median $85.11 Typical High $169.82 | Professional | None | $30.90 | $85.11 | $169.82 |
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 $20.42 Median $41.69 Typical High $69.18 | Professional | 52 · Reduced service | $20.42 | $41.69 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $16.60 Typical High $27.54 | Professional | 53 · Discontinued | $8.13 | $16.60 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $63.10 Typical High $102.33 | Professional | 54 · Surgery only | $30.90 | $63.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $12.59 Typical High $20.42 | Professional | 55 · Aftercare only | $6.17 | $12.59 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $8.32 Typical High $13.80 | Professional | 56 · Pre-op care only | $4.07 | $8.32 | $13.80 |
Where Louisiana sits
The same service costs 5.4 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· 17th of 51
$115
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.