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 $186.21 Median $239.88 Typical High $354.81 | Professional | None | $186.21 | $239.88 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
BCBS Louisiana Setting Facility Modifier None Typical Low $194.98 Median $331.13 Typical High $794.33 | Facility | None | $194.98 | $331.13 | $794.33 |
BCBS Louisiana Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $371.54 | Professional | None | $181.97 | $263.03 | $371.54 |
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 $218.78 Median $346.74 Typical High $676.08 | Facility | None | $218.78 | $346.74 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $398.11 | Professional | None | $138.04 | $234.42 | $398.11 |
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 $123.03 Median $213.80 Typical High $354.81 | Professional | None | $123.03 | $213.80 | $354.81 |
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 $93.33 Median $107.15 Typical High $169.82 | Professional | 52 · Reduced service | $93.33 | $107.15 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $42.66 Typical High $67.61 | Professional | 53 · Discontinued | $37.15 | $42.66 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $162.18 Typical High $257.04 | Professional | 54 · Surgery only | $141.25 | $162.18 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $32.36 Typical High $51.29 | Professional | 55 · Aftercare only | $28.18 | $32.36 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.38 Typical High $33.88 | Professional | 56 · Pre-op care only | $18.62 | $21.38 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $151.36 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $131.83 | $151.36 | $239.88 |
Where Louisiana sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 28th of 51
$234
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.