How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,023 to $14,125Professionalmedian $794 · 10th to 90th $575 to $1,148
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 $616.60 Median $5,011.87 Typical High $14,125.38 | Facility | None | $616.60 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $707.95 | Professional | None | $575.44 | $616.60 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,047.13 | Professional | None | $575.44 | $812.83 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,202.26 Typical High $1,584.89 | Professional | 50 · Both sides | $870.96 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $512.86 Typical High $676.08 | Professional | 62 · Two surgeons | $363.08 | $512.86 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $128.82 Typical High $177.83 | Professional | 80 · Assistant surgeon | $93.33 | $128.82 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $112.20 Typical High $147.91 | Professional | AS · PA/NP assist | $81.28 | $112.20 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $3,235.94 | Facility | None | $691.83 | $691.83 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $3,467.37 | Facility | None | $707.95 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $4,466.84 | Professional | None | $660.69 | $831.76 | $4,466.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,584.89 Median $3,388.44 Typical High $5,248.07 | Facility | None | $1,584.89 | $3,388.44 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $1,318.26 | Professional | None | $645.65 | $954.99 | $1,318.26 |
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 $537.03 Median $691.83 Typical High $1,174.90 | Professional | None | $537.03 | $691.83 | $1,174.90 |
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 $288.40 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $288.40 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $114.82 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $93.33 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $61.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $57.54 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $436.52 | $478.63 |
Where Indiana sits
The same service costs 3.6 times more in Wisconsin 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
WI $7,763MT $2,168
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.