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 $177.83 Median $199.53 Typical High $223.87 | Facility | None | $177.83 | $199.53 | $223.87 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $87.10 Median $102.33 Typical High $107.15 | Facility | 52 · Reduced service | $87.10 | $102.33 | $107.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $30.20 Typical High $32.36 | Facility | 55 · Aftercare only | $26.30 | $30.20 | $32.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.42 Typical High $21.38 | Facility | 56 · Pre-op care only | $17.78 | $20.42 | $21.38 |
Aetna Setting Professional Modifier None (both parts) Typical Low $169.82 Median $194.98 Typical High $229.09 | Professional | None (both parts) | $169.82 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $97.72 Typical High $107.15 | Professional | 52 · Reduced service | $87.10 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $29.51 Typical High $32.36 | Professional | 55 · Aftercare only | $26.30 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.50 Typical High $21.38 | Professional | 56 · Pre-op care only | $17.78 | $19.50 | $21.38 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $147.91 Median $194.98 Typical High $407.38 | Professional | None (both parts) | $147.91 | $194.98 | $407.38 |
BCBS Louisiana Setting Facility Modifier None Typical Low $30.90 Median $56.23 Typical High $416.87 | Facility | None | $30.90 | $56.23 | $416.87 |
BCBS Louisiana Setting Professional Modifier None (both parts) Typical Low $154.88 Median $177.83 Typical High $213.80 | Professional | None (both parts) | $154.88 | $177.83 | $213.80 |
Christus Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None (both parts) Typical Low $138.04 Median $173.78 Typical High $251.19 | Professional | None (both parts) | $138.04 | $173.78 | $251.19 |
United Setting Professional Modifier None (both parts) Typical Low $158.49 Median $204.17 Typical High $302.00 | Professional | None (both parts) | $158.49 | $204.17 | $302.00 |
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 $223.87 Median $223.87 Typical High $234.42 | Facility | AF · Specialist physician | $223.87 | $223.87 | $234.42 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $169.82 Median $169.82 Typical High $177.83 | Facility | HO · Master's level | $169.82 | $169.82 | $177.83 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $190.55 Median $190.55 Typical High $199.53 | Facility | TD · Registered nurse | $190.55 | $190.55 | $199.53 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 26 · Professional part | $204.17 | $204.17 | $204.17 |
Where Louisiana sits
The same service costs 2.4 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· 38th of 51
$191
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.