How much rates vary
Facilitymedian $8,710 · 10th to 90th $1,698 to $30,200Professionalmedian $2,754 · 10th to 90th $2,042 to $4,266
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 $1,380.38 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,380.38 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,187.76 Typical High $2,630.27 | Professional | None | $2,089.30 | $2,187.76 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,398.83 Median $15,488.17 Typical High $33,884.42 | Facility | None | $2,398.83 | $15,488.17 | $33,884.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $3,235.94 Typical High $4,073.80 | Professional | None | $2,041.74 | $3,235.94 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $2,041.74 Typical High $2,570.40 | Professional | 62 · Two surgeons | $1,288.25 | $2,041.74 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $524.81 Typical High $691.83 | Professional | 80 · Assistant surgeon | $323.59 | $524.81 | $691.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $457.09 Typical High $562.34 | Professional | AS · PA/NP assist | $281.84 | $457.09 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,786.30 Typical High $7,943.28 | Facility | None | $645.65 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $10,964.78 | Professional | None | $2,344.23 | $2,691.53 | $10,964.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $6,165.95 Typical High $9,332.54 | Facility | None | $954.99 | $6,165.95 | $9,332.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,454.71 Median $3,388.44 Typical High $4,786.30 | Professional | None | $2,454.71 | $3,388.44 | $4,786.30 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,511.89 Typical High $4,265.80 | Professional | None | $1,905.46 | $2,511.89 | $4,265.80 |
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 $1,047.13 Median $1,096.48 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,047.13 | $1,096.48 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $446.68 Typical High $524.81 | Professional | 53 · Discontinued | $416.87 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,659.59 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,584.89 | $1,659.59 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $331.13 Typical High $389.05 | Professional | 55 · Aftercare only | $316.23 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $218.78 Typical High $263.03 | Professional | 56 · Pre-op care only | $208.93 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,548.82 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,548.82 | $1,819.70 |
Where Indiana sits
The same service costs 4.0 times more in Alaska than in Texas. 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
AK $19,772TX $4,915
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.