How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,318 to $9,550Professionalmedian $2,188 · 10th to 90th $1,445 to $2,630
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 $676.08 Median $2,754.23 Typical High $5,370.32 | Facility | None | $676.08 | $2,754.23 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $2,290.87 Typical High $2,511.89 | Professional | None | $1,621.81 | $2,290.87 | $2,511.89 |
Ambetter Setting Professional Modifier None Typical Low $1,202.26 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,202.26 | $2,041.74 | $2,041.74 |
BCBS Louisiana Setting Facility Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $10,232.93 | Facility | None | $4,365.16 | $5,128.61 | $10,232.93 |
BCBS Louisiana Setting Professional Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,041.74 | $2,511.89 | $2,511.89 |
Christus Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,047.13 Typical High $1,621.81 | Facility | None | $524.81 | $1,047.13 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,548.82 | $1,778.28 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $2,454.71 Typical High $10,471.29 | Facility | None | $1,202.26 | $2,454.71 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,659.59 | $2,818.38 |
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 $1,096.48 Median $1,122.02 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,096.48 | $1,122.02 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $457.09 Typical High $501.19 | Professional | 53 · Discontinued | $436.52 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,698.24 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,659.59 | $1,698.24 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $338.84 Typical High $380.19 | Professional | 55 · Aftercare only | $331.13 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $229.09 Typical High $251.19 | Professional | 56 · Pre-op care only | $218.78 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,584.89 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,584.89 | $1,778.28 |
Where Louisiana sits
The same service costs 9.0 times more in Maine than in Texas. 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.
Physician feeFacility fee
ME $27,654TX $3,070
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.