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 $144.54 Median $2,511.89 Typical High $3,890.45 | Facility | None | $144.54 | $2,511.89 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $162.18 | Professional | None | $112.20 | $131.83 | $162.18 |
BCBS Louisiana Setting Facility Modifier None Typical Low $100.00 Median $239.88 Typical High $741.31 | Facility | None | $100.00 | $239.88 | $741.31 |
BCBS Louisiana Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $194.98 | Professional | None | $112.20 | $147.91 | $194.98 |
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 $89.13 Median $316.23 Typical High $676.08 | Facility | None | $89.13 | $316.23 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $173.78 | Professional | None | $85.11 | $128.82 | $173.78 |
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 $81.28 Median $120.23 Typical High $173.78 | Professional | None | $81.28 | $120.23 | $173.78 |
7 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 $56.23 Median $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $56.23 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $25.12 Typical High $30.20 | Professional | 53 · Discontinued | $22.39 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $95.50 Typical High $114.82 | Professional | 54 · Surgery only | $83.18 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.05 Typical High $22.91 | Professional | 55 · Aftercare only | $16.60 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.59 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.22 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $89.13 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $77.62 | $89.13 | $107.15 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $93.33 Median $151.36 Typical High $151.36 | Professional | 58 · Staged procedure | $93.33 | $151.36 | $151.36 |
Where Louisiana sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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
$141
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.