How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,122 to $14,791Professionalmedian $562 · 10th to 90th $407 to $832
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 $426.58 Median $5,011.87 Typical High $17,782.79 | Facility | None | $426.58 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $489.78 | Professional | None | $389.05 | $426.58 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,659.59 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $794.33 | Professional | None | $407.38 | $616.60 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $933.25 Typical High $1,230.27 | Professional | 50 · Both sides | $616.60 | $933.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $389.05 Typical High $512.86 | Professional | 62 · Two surgeons | $257.04 | $389.05 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $3,235.94 | Facility | None | $467.74 | $467.74 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,137.96 Typical High $4,265.80 | Facility | None | $691.83 | $2,137.96 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $3,388.44 | Professional | None | $457.09 | $575.44 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,230.27 Median $3,388.44 Typical High $5,248.07 | Facility | None | $1,230.27 | $3,388.44 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $933.25 | Professional | None | $489.78 | $676.08 | $933.25 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $812.83 | Professional | None | $363.08 | $478.63 | $812.83 |
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 $194.98 Median $213.80 Typical High $234.42 | Professional | 52 · Reduced service | $194.98 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $93.33 | Professional | 53 · Discontinued | $77.62 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $354.81 | Professional | 54 · Surgery only | $295.12 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $70.79 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $46.77 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $331.13 |
Where Indiana sits
The same service costs 5.1 times more in Washington, DC than in Montana. 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
DC $7,757MT $1,518
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.