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 $141.25 Median $158.49 Typical High $181.97 | Facility | None | $141.25 | $158.49 | $181.97 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $70.79 Median $83.18 Typical High $89.13 | Facility | 52 · Reduced service | $70.79 | $83.18 | $89.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.38 Median $25.12 Typical High $26.30 | Facility | 55 · Aftercare only | $21.38 | $25.12 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.60 Typical High $17.78 | Facility | 56 · Pre-op care only | $14.13 | $16.60 | $17.78 |
Aetna Setting Professional Modifier None (both parts) Typical Low $138.04 Median $158.49 Typical High $190.55 | Professional | None (both parts) | $138.04 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $70.79 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $23.44 Typical High $26.30 | Professional | 55 · Aftercare only | $21.38 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.13 | $15.85 | $17.78 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $151.36 Median $158.49 Typical High $208.93 | Professional | None (both parts) | $151.36 | $158.49 | $208.93 |
BCBS Louisiana Setting Facility Modifier None Typical Low $27.54 Median $50.12 Typical High $331.13 | Facility | None | $27.54 | $50.12 | $331.13 |
BCBS Louisiana Setting Professional Modifier None (both parts) Typical Low $114.82 Median $134.90 Typical High $162.18 | Professional | None (both parts) | $114.82 | $134.90 | $162.18 |
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 (both parts) Typical Low $104.71 Median $131.83 Typical High $194.98 | Professional | None (both parts) | $104.71 | $131.83 | $194.98 |
United Setting Professional Modifier None (both parts) Typical Low $125.89 Median $162.18 Typical High $245.47 | Professional | None (both parts) | $125.89 | $162.18 | $245.47 |
4 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 AF · Specialist physician Typical Low $181.97 Median $181.97 Typical High $190.55 | Facility | AF · Specialist physician | $181.97 | $181.97 | $190.55 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $138.04 Median $138.04 Typical High $144.54 | Facility | HO · Master's level | $138.04 | $138.04 | $144.54 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $154.88 Median $154.88 Typical High $162.18 | Facility | TD · Registered nurse | $154.88 | $154.88 | $162.18 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 26 · Professional part | $165.96 | $165.96 | $165.96 |
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
$155
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.