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 $295.12 Median $1,288.25 Typical High $3,467.37 | Facility | None | $295.12 | $1,288.25 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $323.59 | Professional | None | $229.09 | $257.04 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
BCBS Louisiana Setting Facility Modifier None Typical Low $107.15 Median $1,698.24 Typical High $5,370.32 | Facility | None | $107.15 | $1,698.24 | $5,370.32 |
BCBS Louisiana Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $371.54 | Professional | None | $218.78 | $295.12 | $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 $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 $162.18 Median $245.47 Typical High $331.13 | Professional | None | $162.18 | $245.47 | $331.13 |
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 $162.18 Median $223.87 Typical High $346.74 | Professional | None | $162.18 | $223.87 | $346.74 |
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 $114.82 Median $128.82 Typical High $151.36 | Professional | 52 · Reduced service | $114.82 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $52.48 Typical High $60.26 | Professional | 53 · Discontinued | $45.71 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $194.98 Typical High $229.09 | Professional | 54 · Surgery only | $169.82 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.90 Typical High $45.71 | Professional | 55 · Aftercare only | $33.88 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.70 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.91 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $181.97 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $158.49 | $181.97 | $213.80 |
Where Louisiana sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 21st of 51
$295
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.