How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,122 to $16,982Professionalmedian $1,862 · 10th to 90th $1,413 to $2,692
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 $11,220.18 | Facility | None | $1,380.38 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,412.54 | $1,479.11 | $1,819.70 |
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 $1,412.54 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,862.09 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,174.90 Typical High $1,584.89 | Professional | 62 · Two surgeons | $891.25 | $1,174.90 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $302.00 Typical High $407.38 | Professional | 80 · Assistant surgeon | $229.09 | $302.00 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $263.03 Typical High $354.81 | Professional | AS · PA/NP assist | $199.53 | $263.03 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $8,912.51 Typical High $14,791.08 | Facility | None | $645.65 | $8,912.51 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $9,332.54 | Professional | None | $1,584.89 | $1,862.09 | $9,332.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $4,365.16 Typical High $17,782.79 | Facility | None | $954.99 | $4,365.16 | $17,782.79 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $3,235.94 | Professional | None | $1,698.24 | $2,344.23 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,698.24 | $2,818.38 |
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 $707.95 Median $741.31 Typical High $912.01 | Professional | 52 · Reduced service | $707.95 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $295.12 Typical High $363.08 | Professional | 53 · Discontinued | $281.84 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,096.48 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,047.13 | $1,096.48 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $223.87 Typical High $275.42 | Professional | 55 · Aftercare only | $213.80 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $147.91 Typical High $181.97 | Professional | 56 · Pre-op care only | $141.25 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,023.29 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $977.24 | $1,023.29 | $1,258.93 |
Where Indiana sits
The same service costs 5.3 times more in Alaska 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
AK $17,981KY $3,363
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.