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 $165.96 Median $2,511.89 Typical High $3,890.45 | Facility | None | $165.96 | $2,511.89 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $181.97 | Professional | None | $123.03 | $144.54 | $181.97 |
BCBS Louisiana Setting Facility Modifier None Typical Low $123.03 Median $1,659.59 Typical High $5,128.61 | Facility | None | $123.03 | $1,659.59 | $5,128.61 |
BCBS Louisiana Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $229.09 | Professional | None | $123.03 | $162.18 | $229.09 |
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 $102.33 Median $524.81 Typical High $1,174.90 | Facility | None | $102.33 | $524.81 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $199.53 | Professional | None | $100.00 | $144.54 | $199.53 |
United Setting Facility Modifier None Typical Low $446.68 Median $954.99 Typical High $3,630.78 | Facility | None | $446.68 | $954.99 | $3,630.78 |
United Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $213.80 | Professional | None | $87.10 | $125.89 | $213.80 |
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 $61.66 Median $72.44 Typical High $85.11 | Professional | 52 · Reduced service | $61.66 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $29.51 Typical High $34.67 | Professional | 53 · Discontinued | $24.55 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $109.65 Typical High $128.82 | Professional | 54 · Surgery only | $93.33 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.88 Typical High $25.70 | Professional | 55 · Aftercare only | $18.62 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.45 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.30 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $102.33 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $87.10 | $102.33 | $120.23 |
Where Louisiana sits
The same service costs 3.5 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· 23rd 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.