How much rates vary
Facilitymedian $13,804 · 10th to 90th $1,738 to $33,113Professionalmedian $2,455 · 10th to 90th $1,738 to $3,802
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 $1,778.28 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,778.28 | $1,905.46 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,398.83 Median $15,488.17 Typical High $38,904.51 | Facility | None | $2,398.83 | $15,488.17 | $38,904.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,818.38 Typical High $3,467.37 | Professional | None | $1,737.80 | $2,818.38 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,778.28 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,096.48 | $1,778.28 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $446.68 Typical High $602.56 | Professional | 80 · Assistant surgeon | $281.84 | $446.68 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $389.05 Typical High $501.19 | Professional | AS · PA/NP assist | $245.47 | $389.05 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $18,197.01 Typical High $30,199.52 | Facility | None | $645.65 | $18,197.01 | $30,199.52 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $19,498.45 | Professional | None | $2,089.30 | $2,511.89 | $19,498.45 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $5,248.07 Typical High $34,673.69 | Facility | None | $954.99 | $5,248.07 | $34,673.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,089.30 Median $2,884.03 Typical High $4,168.69 | Professional | None | $2,089.30 | $2,884.03 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $8,912.51 Typical High $16,218.10 | Facility | None | $1,621.81 | $8,912.51 | $16,218.10 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $3,715.35 | Professional | None | $1,659.59 | $2,290.87 | $3,715.35 |
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 $891.25 Median $954.99 Typical High $1,122.02 | Professional | 52 · Reduced service | $891.25 | $954.99 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $389.05 Typical High $446.68 | Professional | 53 · Discontinued | $354.81 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,445.44 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,348.96 | $1,445.44 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $288.40 Typical High $338.84 | Professional | 55 · Aftercare only | $269.15 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $190.55 Typical High $223.87 | Professional | 56 · Pre-op care only | $177.83 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,348.96 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,348.96 | $1,584.89 |
Where Indiana sits
The same service costs 5.2 times more in Wyoming 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
WY $23,952KY $4,650
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.