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 $100.00 Median $102.33 Typical High $112.20 | Facility | None | $100.00 | $102.33 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $177.83 | Professional | None | $81.28 | $120.23 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $97.72 | Professional | None | $61.66 | $72.44 | $97.72 |
BCBS Louisiana Setting Facility Modifier None Typical Low $107.15 Median $194.98 Typical High $295.12 | Facility | None | $107.15 | $194.98 | $295.12 |
BCBS Louisiana Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $131.83 | Professional | None | $70.79 | $83.18 | $131.83 |
Christus Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $173.78 | Professional | None | $63.10 | $79.43 | $173.78 |
United Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $158.49 | Professional | None | $75.86 | $102.33 | $158.49 |
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 $50.12 Median $51.29 Typical High $53.70 | Facility | 52 · Reduced service | $50.12 | $51.29 | $53.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $15.14 Typical High $16.22 | Facility | 55 · Aftercare only | $14.79 | $15.14 | $16.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $10.96 | Facility | 56 · Pre-op care only | $10.00 | $10.23 | $10.96 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | AF · Specialist physician | $128.82 | $128.82 | $128.82 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | HO · Master's level | $128.82 | $128.82 | $128.82 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | TD · Registered nurse | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $50.12 Typical High $53.70 | Professional | 52 · Reduced service | $39.81 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.14 Typical High $16.22 | Professional | 55 · Aftercare only | $12.02 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.00 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.94 | $10.00 | $10.96 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $72.44 Median $72.44 Typical High $85.11 | Professional | 25 · Same-day visit | $72.44 | $72.44 | $85.11 |
Ambetter Setting Professional Modifier AI · Physician of record Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | AI · Physician of record | $83.18 | $83.18 | $83.18 |
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· 34th of 51
$102
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.