How much rates vary
Facilitymedian $5,012 · 10th to 90th $741 to $11,482Professionalmedian $1,000 · 10th to 90th $676 to $1,549
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 $724.44 Median $5,011.87 Typical High $5,623.41 | Facility | None | $724.44 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $831.76 | Professional | None | $676.08 | $724.44 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $10,000.00 | Facility | None | $741.31 | $5,370.32 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $1,148.15 Typical High $1,380.38 | Professional | None | $630.96 | $1,148.15 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $181.97 Typical High $245.47 | Professional | 80 · Assistant surgeon | $100.00 | $181.97 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $162.18 Typical High $199.53 | Professional | AS · PA/NP assist | $87.10 | $162.18 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $2,691.53 | Facility | None | $524.81 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $11,481.54 | Professional | None | $812.83 | $1,023.29 | $11,481.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,905.46 Typical High $2,187.76 | Facility | None | $912.01 | $1,905.46 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,584.89 | Professional | None | $758.58 | $1,122.02 | $1,584.89 |
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 $645.65 Median $912.01 Typical High $1,513.56 | Professional | None | $645.65 | $912.01 | $1,513.56 |
5 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 $338.84 Median $363.08 Typical High $407.38 | Professional | 52 · Reduced service | $338.84 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $147.91 Typical High $165.96 | Professional | 53 · Discontinued | $134.90 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $549.54 Typical High $616.60 | Professional | 54 · Surgery only | $512.86 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $123.03 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $83.18 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $83.18 |
Where Indiana sits
The same service costs 4.6 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 $9,843KY $2,122
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.