How much rates vary
Facilitymedian $5,754 · 10th to 90th $708 to $25,119Professionalmedian $891 · 10th to 90th $550 to $1,318
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 $630.96 Median $891.25 Typical High $7,244.36 | Facility | None | $630.96 | $891.25 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $870.96 | Professional | None | $630.96 | $630.96 | $870.96 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 50 · Both sides | $478.63 | $478.63 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $11,220.18 Typical High $28,840.32 | Facility | None | $851.14 | $11,220.18 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $977.24 Typical High $1,288.25 | Professional | None | $575.44 | $977.24 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,479.11 Typical High $1,949.84 | Professional | 50 · Both sides | $912.01 | $1,479.11 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $616.60 Typical High $812.83 | Professional | 62 · Two surgeons | $363.08 | $616.60 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $5,623.41 | Facility | None | $776.25 | $776.25 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,073.80 Typical High $6,918.31 | Facility | None | $549.54 | $4,073.80 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $831.76 Typical High $1,288.25 | Professional | None | $457.09 | $831.76 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,949.84 Median $6,025.60 Typical High $9,549.93 | Facility | None | $1,949.84 | $6,025.60 | $9,549.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,412.54 | Professional | None | $776.25 | $977.24 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,677.35 | $12,022.64 |
United Setting Professional Modifier None Typical Low $398.11 Median $954.99 Typical High $1,584.89 | Professional | None | $398.11 | $954.99 | $1,584.89 |
6 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 $316.23 Median $316.23 Typical High $426.58 | Professional | 52 · Reduced service | $316.23 | $316.23 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | 53 · Discontinued | $125.89 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | 54 · Surgery only | $467.74 | $467.74 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $85.11 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $588.84 |
Where Indiana sits
The same service costs 6.0 times more in Colorado than in Hawaii. 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.
Physician feeFacility fee
CO $12,924HI $2,150
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.