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 $38.02 Median $38.90 Typical High $42.66 | Facility | None | $38.02 | $38.90 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $83.18 | Professional | None | $37.15 | $45.71 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $36.31 Median $47.86 Typical High $57.54 | Professional | None | $36.31 | $47.86 | $57.54 |
BCBS Louisiana Setting Facility Modifier None Typical Low $0.02 Median $0.02 Typical High $0.03 | Facility | None | $0.02 | $0.02 | $0.03 |
BCBS Louisiana Setting Professional Modifier None Typical Low $42.66 Median $50.12 Typical High $51.29 | Professional | None | $42.66 | $50.12 | $51.29 |
Christus Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $83.18 | Professional | None | $38.02 | $41.69 | $83.18 |
United Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $61.66 | Professional | None | $32.36 | $41.69 | $61.66 |
9 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 $19.05 Median $19.50 Typical High $20.89 | Facility | 52 · Reduced service | $19.05 | $19.50 | $20.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $5.89 Typical High $6.31 | Facility | 55 · Aftercare only | $5.75 | $5.89 | $6.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.89 Typical High $4.17 | Facility | 56 · Pre-op care only | $3.80 | $3.89 | $4.17 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | AF · Specialist physician | $83.18 | $83.18 | $83.18 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | HO · Master's level | $83.18 | $83.18 | $83.18 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | TD · Registered nurse | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $19.50 Typical High $20.89 | Professional | 52 · Reduced service | $18.62 | $19.50 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.89 Typical High $6.31 | Professional | 55 · Aftercare only | $5.62 | $5.89 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.89 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.80 | $3.89 | $4.17 |
Where Louisiana sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 43rd of 51
$43.65
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.