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 $338.84 Median $1,288.25 Typical High $3,467.37 | Facility | None | $338.84 | $1,288.25 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $380.19 | Professional | None | $223.87 | $302.00 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
BCBS Louisiana Setting Facility Modifier None Typical Low $239.88 Median $2,511.89 Typical High $5,754.40 | Facility | None | $239.88 | $2,511.89 | $5,754.40 |
BCBS Louisiana Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $398.11 | Professional | None | $213.80 | $281.84 | $398.11 |
Christus Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $446.68 Typical High $676.08 | Facility | None | $223.87 | $446.68 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $436.52 | Professional | None | $158.49 | $245.47 | $436.52 |
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 $162.18 Median $257.04 Typical High $416.87 | Professional | None | $162.18 | $257.04 | $416.87 |
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 $112.20 Median $125.89 Typical High $181.97 | Professional | 52 · Reduced service | $112.20 | $125.89 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $50.12 Typical High $72.44 | Professional | 53 · Discontinued | $44.67 | $50.12 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $186.21 Typical High $269.15 | Professional | 54 · Surgery only | $165.96 | $186.21 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $37.15 Typical High $53.70 | Professional | 55 · Aftercare only | $33.11 | $37.15 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.12 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.39 | $25.12 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $173.78 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $154.88 | $173.78 | $251.19 |
Where Louisiana sits
The same service costs 4.3 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· 17th of 51
$331
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.