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 $109.65 Median $125.89 Typical High $134.90 | Facility | None | $109.65 | $125.89 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $134.90 | Professional | None | $97.72 | $123.03 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $120.23 Median $128.82 Typical High $128.82 | Professional | None | $120.23 | $128.82 | $128.82 |
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 $104.71 Median $107.15 Typical High $208.93 | Professional | None | $104.71 | $107.15 | $208.93 |
United Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $190.55 | Professional | None | $97.72 | $125.89 | $190.55 |
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 $61.66 Median $63.10 Typical High $67.61 | Facility | 52 · Reduced service | $61.66 | $63.10 | $67.61 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $19.05 Typical High $20.42 | Facility | 55 · Aftercare only | $18.62 | $19.05 | $20.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.59 Typical High $13.49 | Facility | 56 · Pre-op care only | $12.30 | $12.59 | $13.49 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $128.82 Median $131.83 Typical High $144.54 | Facility | AF · Specialist physician | $128.82 | $131.83 | $144.54 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $97.72 Median $97.72 Typical High $109.65 | Facility | HO · Master's level | $97.72 | $97.72 | $109.65 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $109.65 Median $112.20 Typical High $123.03 | Facility | TD · Registered nurse | $109.65 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $63.10 Typical High $67.61 | Professional | 52 · Reduced service | $61.66 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.05 Typical High $20.42 | Professional | 55 · Aftercare only | $18.62 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.59 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.30 | $12.59 | $13.49 |
Where Louisiana sits
The same service costs 2.1 times more in Wisconsin than in Ohio. 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
$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.