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 $398.11 Median $1,288.25 Typical High $3,467.37 | Facility | None | $398.11 | $1,288.25 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $33.88 Typical High $37.15 | Professional | None | $27.54 | $33.88 | $37.15 |
BCBS Louisiana Setting Facility Modifier None Typical Low $162.18 Median $295.12 Typical High $1,000.00 | Facility | None | $162.18 | $295.12 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $524.81 Typical High $1,174.90 | Facility | None | $151.36 | $524.81 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $58.88 Typical High $74.13 | Professional | None | $36.31 | $58.88 | $74.13 |
United Setting Facility Modifier None Typical Low $91.20 Median $363.08 Typical High $1,202.26 | Facility | None | $91.20 | $363.08 | $1,202.26 |
United Setting Professional Modifier None Typical Low $19.50 Median $27.54 Typical High $45.71 | Professional | None | $19.50 | $27.54 | $45.71 |
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 $13.80 Median $16.98 Typical High $17.78 | Professional | 52 · Reduced service | $13.80 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $6.76 Typical High $7.08 | Professional | 53 · Discontinued | $5.62 | $6.76 | $7.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $25.12 Typical High $26.92 | Professional | 54 · Surgery only | $20.89 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $5.01 Typical High $5.37 | Professional | 55 · Aftercare only | $4.17 | $5.01 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $3.39 Typical High $3.55 | Professional | 56 · Pre-op care only | $2.75 | $3.39 | $3.55 |
Where Louisiana sits
The same service costs 9.1 times more in Tennessee than in Maine. 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· 5th of 51
$162
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.