How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,047 to $15,136Professionalmedian $912 · 10th to 90th $741 to $1,413
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 $794.33 Median $5,011.87 Typical High $11,220.18 | Facility | None | $794.33 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $912.01 | Professional | None | $758.58 | $794.33 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,230.27 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,202.26 | Professional | None | $741.31 | $912.01 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $575.44 Typical High $776.25 | Professional | 62 · Two surgeons | $467.74 | $575.44 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $147.91 Typical High $208.93 | Professional | 80 · Assistant surgeon | $120.23 | $147.91 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $128.82 Typical High $173.78 | Professional | AS · PA/NP assist | $102.33 | $128.82 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $933.25 Typical High $1,412.54 | Facility | None | $912.01 | $933.25 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,466.84 Typical High $7,762.47 | Facility | None | $851.14 | $4,466.84 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $4,570.88 | Professional | None | $831.76 | $977.24 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $2,630.27 Typical High $10,471.29 | Facility | None | $954.99 | $2,630.27 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $1,778.28 | Professional | None | $794.33 | $1,258.93 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,248.07 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,248.07 | $14,454.40 |
United Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,513.56 | Professional | None | $676.08 | $912.01 | $1,513.56 |
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 $380.19 Median $398.11 Typical High $457.09 | Professional | 52 · Reduced service | $380.19 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $181.97 | Professional | 53 · Discontinued | $151.36 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $691.83 | Professional | 54 · Surgery only | $562.34 | $602.56 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $91.20 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $645.65 |
Where Indiana sits
The same service costs 5.1 times more in Oklahoma than in Kentucky. 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
OK $11,738KY $2,311
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.