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 $5.25 Median $5.62 Typical High $6.46 | Facility | None | $5.25 | $5.62 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $5.62 Typical High $7.08 | Professional | None | $5.50 | $5.62 | $7.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.75 Median $2.82 Typical High $3.55 | Professional | 52 · Reduced service | $2.75 | $2.82 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.12 Typical High $1.45 | Professional | 53 · Discontinued | $1.10 | $1.12 | $1.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.85 Typical High $1.07 | Professional | 55 · Aftercare only | $0.81 | $0.85 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.56 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.55 | $0.56 | $0.71 |
Ambetter Setting Professional Modifier None Typical Low $3.80 Median $4.47 Typical High $7.41 | Professional | None | $3.80 | $4.47 | $7.41 |
BCBS Louisiana Setting Facility Modifier None Typical Low $36.31 Median $72.44 Typical High $114.82 | Facility | None | $36.31 | $72.44 | $114.82 |
BCBS Louisiana Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $5.13 | Professional | None | $3.47 | $3.47 | $5.13 |
Christus Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.24 Typical High $5.37 | Professional | None | $3.02 | $3.24 | $5.37 |
United Setting Facility Modifier None Typical Low $42.66 Median $56.23 Typical High $104.71 | Facility | None | $42.66 | $56.23 | $104.71 |
United Setting Professional Modifier None Typical Low $3.89 Median $5.01 Typical High $8.71 | Professional | None | $3.89 | $5.01 | $8.71 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $3.80 Median $3.80 Typical High $4.47 | Professional | 59 · Distinct service | $3.80 | $3.80 | $4.47 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | GC · Resident with teaching physician | $5.25 | $5.25 | $5.25 |
Where Louisiana sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 31st of 51
$4.90
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.