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 $281.84 Median $1,258.93 Typical High $3,467.37 | Facility | None | $281.84 | $1,258.93 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $309.03 | Professional | None | $165.96 | $229.09 | $309.03 |
BCBS Louisiana Setting Facility Modifier None Typical Low $190.55 Median $2,511.89 Typical High $5,754.40 | Facility | None | $190.55 | $2,511.89 | $5,754.40 |
BCBS Louisiana Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $338.84 | Professional | None | $158.49 | $234.42 | $338.84 |
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 $181.97 Median $524.81 Typical High $1,174.90 | Facility | None | $181.97 | $524.81 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $363.08 | Professional | None | $120.23 | $204.17 | $363.08 |
United Setting Facility Modifier None Typical Low $446.68 Median $954.99 Typical High $4,466.84 | Facility | None | $446.68 | $954.99 | $4,466.84 |
United Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $338.84 | Professional | None | $123.03 | $204.17 | $338.84 |
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 $83.18 Median $95.50 Typical High $147.91 | Professional | 52 · Reduced service | $83.18 | $95.50 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $38.02 Typical High $58.88 | Professional | 53 · Discontinued | $33.11 | $38.02 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $141.25 Typical High $223.87 | Professional | 54 · Surgery only | $125.89 | $141.25 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.18 Typical High $44.67 | Professional | 55 · Aftercare only | $25.12 | $28.18 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.05 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.60 | $19.05 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $131.83 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $117.49 | $131.83 | $208.93 |
Where Louisiana sits
The same service costs 3.8 times more in Wisconsin than in Kentucky. 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· 20th of 51
$251
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.