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 $190.55 Median $1,148.15 Typical High $3,467.37 | Facility | None | $190.55 | $1,148.15 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $204.17 | Professional | None | $147.91 | $181.97 | $204.17 |
BCBS Louisiana Setting Facility Modifier None Typical Low $87.10 Median $112.20 Typical High $630.96 | Facility | None | $87.10 | $112.20 | $630.96 |
BCBS Louisiana Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $218.78 | Professional | None | $144.54 | $190.55 | $218.78 |
Christus Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $316.23 Typical High $676.08 | Facility | None | $95.50 | $316.23 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $208.93 | Professional | None | $120.23 | $158.49 | $208.93 |
United Setting Facility Modifier None Typical Low $91.20 Median $380.19 Typical High $1,202.26 | Facility | None | $91.20 | $380.19 | $1,202.26 |
United Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $251.19 | Professional | None | $104.71 | $144.54 | $251.19 |
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 $83.18 Median $91.20 Typical High $97.72 | Professional | 52 · Reduced service | $83.18 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $36.31 Typical High $38.90 | Professional | 53 · Discontinued | $33.11 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $138.04 Typical High $147.91 | Professional | 54 · Surgery only | $123.03 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $27.54 Typical High $29.51 | Professional | 55 · Aftercare only | $24.55 | $27.54 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.20 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.60 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $128.82 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $114.82 | $128.82 | $138.04 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $239.88 Typical High $245.47 | Professional | 50 · Both sides | $223.87 | $239.88 | $245.47 |
Where Louisiana sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 27th of 51
$174
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.