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 $72.44 Median $83.18 Typical High $89.13 | Facility | None | $72.44 | $83.18 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $89.13 | Professional | None | $64.57 | $81.28 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
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 $72.44 Median $77.62 Typical High $77.62 | Professional | None | $72.44 | $77.62 | $77.62 |
Christus Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $64.57 Typical High $128.82 | Professional | None | $63.10 | $64.57 | $128.82 |
United Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $125.89 | Professional | None | $64.57 | $83.18 | $125.89 |
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 $40.74 Median $41.69 Typical High $43.65 | Facility | 52 · Reduced service | $40.74 | $41.69 | $43.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.30 Typical High $13.18 | Facility | 55 · Aftercare only | $12.02 | $12.30 | $13.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.32 Typical High $8.91 | Facility | 56 · Pre-op care only | $8.13 | $8.32 | $8.91 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $85.11 Median $87.10 Typical High $95.50 | Facility | AF · Specialist physician | $85.11 | $87.10 | $95.50 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $64.57 Median $66.07 Typical High $72.44 | Facility | HO · Master's level | $64.57 | $66.07 | $72.44 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $72.44 Median $74.13 Typical High $81.28 | Facility | TD · Registered nurse | $72.44 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $41.69 Typical High $43.65 | Professional | 52 · Reduced service | $40.74 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.30 Typical High $13.18 | Professional | 55 · Aftercare only | $12.02 | $12.30 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.32 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.13 | $8.32 | $8.91 |
Where Louisiana sits
The same service costs 2.1 times more in Oregon 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· 29th of 51
$81.28
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.