How much rates vary
Facilitymedian $79 · 10th to 90th $51 to $178Professionalmedian $93 · 10th to 90th $69 to $126
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 $75.86 Median $102.33 Typical High $114.82 | Facility | None | $75.86 | $102.33 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $114.82 | Professional | None | $75.86 | $95.50 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $109.65 Typical High $147.91 | Professional | None | $58.88 | $109.65 | $147.91 |
BCBS Louisiana Setting Facility Modifier None Typical Low $36.31 Median $69.18 Typical High $234.42 | Facility | None | $36.31 | $69.18 | $234.42 |
BCBS Louisiana Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $107.15 | Professional | None | $79.43 | $91.20 | $107.15 |
Christus Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $151.36 Typical High $169.82 | Facility | None | $128.82 | $151.36 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $114.82 | Professional | None | $67.61 | $91.20 | $114.82 |
United Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $134.90 | Professional | None | $63.10 | $93.33 | $134.90 |
12 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 $37.15 Median $41.69 Typical High $54.95 | Facility | 52 · Reduced service | $37.15 | $41.69 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $12.59 Typical High $16.22 | Facility | 55 · Aftercare only | $11.22 | $12.59 | $16.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.32 Typical High $10.96 | Facility | 56 · Pre-op care only | $7.41 | $8.32 | $10.96 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $107.15 Median $112.20 Typical High $120.23 | Facility | AF · Specialist physician | $107.15 | $112.20 | $120.23 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $79.43 Median $83.18 Typical High $91.20 | Facility | HO · Master's level | $79.43 | $83.18 | $91.20 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $91.20 Median $95.50 Typical High $102.33 | Facility | TD · Registered nurse | $91.20 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $40.74 Typical High $54.95 | Professional | 52 · Reduced service | $37.15 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.30 Typical High $16.22 | Professional | 55 · Aftercare only | $10.96 | $12.30 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.13 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.41 | $8.13 | $10.96 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $93.33 Median $112.20 Typical High $154.88 | Professional | 25 · Same-day visit | $93.33 | $112.20 | $154.88 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 57 · Decision for surgery | $147.91 | $147.91 | $147.91 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $79.43 Median $181.97 Typical High $181.97 | Professional | GC · Resident with teaching physician | $79.43 | $181.97 | $181.97 |
Where Louisiana sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 36th of 51
$93.33
AK $170AL $74.13
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.