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 $117.49 Median $131.83 Typical High $141.25 | Facility | None | $117.49 | $131.83 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $151.36 | Professional | None | $102.33 | $128.82 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $100.00 Typical High $102.33 | Professional | None | $97.72 | $100.00 | $102.33 |
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 $85.11 Median $100.00 Typical High $177.83 | Professional | None | $85.11 | $100.00 | $177.83 |
Christus Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $229.09 | Professional | None | $75.86 | $93.33 | $229.09 |
United Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $213.80 | Professional | None | $109.65 | $141.25 | $213.80 |
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 $64.57 Median $66.07 Typical High $70.79 | Facility | 52 · Reduced service | $64.57 | $66.07 | $70.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $19.95 Typical High $21.38 | Facility | 55 · Aftercare only | $19.50 | $19.95 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.18 Typical High $14.13 | Facility | 56 · Pre-op care only | $12.88 | $13.18 | $14.13 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $138.04 Median $141.25 Typical High $154.88 | Facility | AF · Specialist physician | $138.04 | $141.25 | $154.88 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $102.33 Median $104.71 Typical High $117.49 | Facility | HO · Master's level | $102.33 | $104.71 | $117.49 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $117.49 Median $120.23 Typical High $131.83 | Facility | TD · Registered nurse | $117.49 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $66.07 Typical High $70.79 | Professional | 52 · Reduced service | $53.70 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.95 Typical High $21.38 | Professional | 55 · Aftercare only | $15.85 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.18 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.72 | $13.18 | $14.13 |
Where Louisiana sits
The same service costs 2.0 times more in Alaska than in Washington, DC. 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· 33rd of 51
$123
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.