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 $120.23 Median $158.49 Typical High $537.03 | Facility | None | $120.23 | $158.49 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $147.91 | Professional | None | $74.13 | $125.89 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $61.66 Typical High $120.23 | Professional | None | $38.02 | $61.66 | $120.23 |
BCBS Louisiana Setting Facility Modifier None Typical Low $114.82 Median $204.17 Typical High $302.00 | Facility | None | $114.82 | $204.17 | $302.00 |
BCBS Louisiana Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Christus Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $288.40 Typical High $524.81 | Facility | None | $128.82 | $288.40 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $75.86 | Professional | None | $60.26 | $60.26 | $75.86 |
United Setting Facility Modifier None Typical Low $47.86 Median $102.33 Typical High $114.82 | Facility | None | $47.86 | $102.33 | $114.82 |
United Setting Professional Modifier None Typical Low $33.88 Median $47.86 Typical High $81.28 | Professional | None | $33.88 | $47.86 | $81.28 |
10 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 $60.26 Median $77.62 Typical High $295.12 | Facility | 52 · Reduced service | $60.26 | $77.62 | $295.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $31.62 Typical High $117.49 | Facility | 53 · Discontinued | $23.99 | $31.62 | $117.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $91.20 Median $117.49 Typical High $436.52 | Facility | 54 · Surgery only | $91.20 | $117.49 | $436.52 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.20 Median $23.44 Typical High $87.10 | Facility | 55 · Aftercare only | $18.20 | $23.44 | $87.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.49 Typical High $58.88 | Facility | 56 · Pre-op care only | $12.02 | $15.49 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $69.18 Typical High $74.13 | Professional | 52 · Reduced service | $60.26 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $27.54 Typical High $29.51 | Professional | 53 · Discontinued | $23.99 | $27.54 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $104.71 Typical High $112.20 | Professional | 54 · Surgery only | $91.20 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.89 Typical High $22.39 | Professional | 55 · Aftercare only | $18.20 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.80 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.02 | $13.80 | $14.79 |
Where Louisiana sits
The same service costs 4.9 times more in Alaska than in Georgia. 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· 17th of 51
$112
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.