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 $6.76 Median $6.76 Typical High $10.23 | Facility | None | $6.76 | $6.76 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $7.24 Typical High $10.47 | Professional | None | $6.76 | $7.24 | $10.47 |
Ambetter Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
BCBS Louisiana Setting Facility Modifier None Typical Low $10.96 Median $19.05 Typical High $26.92 | Facility | None | $10.96 | $19.05 | $26.92 |
BCBS Louisiana Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
Christus Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
United Setting Facility Modifier None Typical Low $6.31 Median $15.14 Typical High $15.14 | Facility | None | $6.31 | $15.14 | $15.14 |
United Setting Professional Modifier None Typical Low $3.72 Median $6.03 Typical High $8.32 | Professional | None | $3.72 | $6.03 | $8.32 |
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 Professional Modifier 52 · Reduced service Typical Low $3.39 Median $3.63 Typical High $5.25 | Professional | 52 · Reduced service | $3.39 | $3.63 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $1.45 Typical High $2.09 | Professional | 53 · Discontinued | $1.35 | $1.45 | $2.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.02 Median $1.10 Typical High $1.58 | Professional | 55 · Aftercare only | $1.02 | $1.10 | $1.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.72 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.68 | $0.72 | $1.05 |
Where Louisiana sits
The same service costs 3.5 times more in Montana than in Kansas. 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· 20th of 51
$8.32
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.