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 $21.38 Median $398.11 Typical High $3,467.37 | Facility | None | $21.38 | $398.11 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $21.88 Typical High $32.36 | Professional | None | $17.38 | $21.88 | $32.36 |
BCBS Louisiana Setting Facility Modifier None Typical Low $22.39 Median $36.31 Typical High $67.61 | Facility | None | $22.39 | $36.31 | $67.61 |
BCBS Louisiana Setting Professional Modifier None Typical Low $15.14 Median $19.95 Typical High $26.92 | Professional | None | $15.14 | $19.95 | $26.92 |
Christus Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Facility | None | $15.49 | $15.49 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $19.50 Median $39.81 Typical High $109.65 | Facility | None | $19.50 | $39.81 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $12.02 Typical High $20.42 | Professional | None | $8.51 | $12.02 | $20.42 |
United Setting Facility Modifier None Typical Low $7.59 Median $16.22 Typical High $18.20 | Facility | None | $7.59 | $16.22 | $18.20 |
United Setting Professional Modifier None Typical Low $7.59 Median $10.47 Typical High $24.55 | Professional | None | $7.59 | $10.47 | $24.55 |
11 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 Facility Modifier 52 · Reduced service Typical Low $9.55 Median $12.30 Typical High $45.71 | Facility | 52 · Reduced service | $9.55 | $12.30 | $45.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.80 Median $4.90 Typical High $18.62 | Facility | 53 · Discontinued | $3.80 | $4.90 | $18.62 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $14.45 Median $18.62 Typical High $69.18 | Facility | 54 · Surgery only | $14.45 | $18.62 | $69.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.88 Median $3.72 Typical High $13.80 | Facility | 55 · Aftercare only | $2.88 | $3.72 | $13.80 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.45 Typical High $9.12 | Facility | 56 · Pre-op care only | $1.91 | $2.45 | $9.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.55 Median $10.96 Typical High $11.75 | Professional | 52 · Reduced service | $9.55 | $10.96 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $4.37 Typical High $4.68 | Professional | 53 · Discontinued | $3.80 | $4.37 | $4.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.45 Median $16.22 Typical High $17.38 | Professional | 54 · Surgery only | $14.45 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.24 Typical High $3.55 | Professional | 55 · Aftercare only | $2.88 | $3.24 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.19 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.91 | $2.19 | $2.34 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | 90 · Outside lab | $10.72 | $10.72 | $12.59 |
Where Louisiana sits
The same service costs 3.0 times more in South Carolina than in Maryland. 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· 20th of 51
$19.95
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.