How much rates vary
Facilitymedian $776 · 10th to 90th $126 to $4,074Professionalmedian $214 · 10th to 90th $145 to $316
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 $288.40 Median $1,288.25 Typical High $3,467.37 | Facility | None | $288.40 | $1,288.25 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $281.84 | Professional | None | $173.78 | $208.93 | $281.84 |
BCBS Louisiana Setting Facility Modifier None Typical Low $138.04 Median $1,698.24 Typical High $5,128.61 | Facility | None | $138.04 | $1,698.24 | $5,128.61 |
BCBS Louisiana Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $331.13 | Professional | None | $169.82 | $223.87 | $331.13 |
Christus Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $645.65 Typical High $1,778.28 | Facility | None | $331.13 | $645.65 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $288.40 | Professional | None | $141.25 | $204.17 | $288.40 |
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 $128.82 Median $190.55 Typical High $295.12 | Professional | None | $128.82 | $190.55 | $295.12 |
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 $87.10 Median $104.71 Typical High $128.82 | Professional | 52 · Reduced service | $87.10 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $41.69 Typical High $51.29 | Professional | 53 · Discontinued | $34.67 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $154.88 Typical High $194.98 | Professional | 54 · Surgery only | $131.83 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.90 Typical High $38.90 | Professional | 55 · Aftercare only | $26.30 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $17.38 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $144.54 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $123.03 | $144.54 | $181.97 |
Where Louisiana sits
The same service costs 9.9 times more in Colorado than in Montana. 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
CO $4,605MT $466
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.