How much rates vary
Facilitymedian $6,457 · 10th to 90th $871 to $28,840Professionalmedian $479 · 10th to 90th $380 to $741
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 $389.05 Median $5,011.87 Typical High $11,220.18 | Facility | None | $389.05 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $457.09 | Professional | None | $363.08 | $389.05 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,122.02 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $691.83 | Professional | None | $380.19 | $549.54 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $87.10 Typical High $117.49 | Professional | 80 · Assistant surgeon | $60.26 | $87.10 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $75.86 Typical High $100.00 | Professional | AS · PA/NP assist | $53.70 | $75.86 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $7,244.36 | Facility | None | $436.52 | $436.52 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $4,168.69 Typical High $7,762.47 | Facility | None | $524.81 | $4,168.69 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $2,570.40 | Professional | None | $416.87 | $489.78 | $2,570.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,148.15 Median $6,606.93 Typical High $10,471.29 | Facility | None | $1,148.15 | $6,606.93 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $851.14 | Professional | None | $457.09 | $616.60 | $851.14 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $741.31 | Professional | None | $338.84 | $446.68 | $741.31 |
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 $181.97 Median $190.55 Typical High $223.87 | Professional | 52 · Reduced service | $181.97 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $77.62 Typical High $89.13 | Professional | 53 · Discontinued | $72.44 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $288.40 Typical High $331.13 | Professional | 54 · Surgery only | $275.42 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $57.54 Typical High $66.07 | Professional | 55 · Aftercare only | $54.95 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.90 Typical High $44.67 | Professional | 56 · Pre-op care only | $36.31 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $269.15 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $257.04 | $269.15 | $309.03 |
Where Indiana sits
The same service costs 8.5 times more in Colorado than in Montana. 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 $11,809MT $1,385
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.