How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,047 to $14,125Professionalmedian $832 · 10th to 90th $603 to $1,230
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 $588.84 Median $616.60 Typical High $724.44 | Professional | None | $588.84 | $616.60 | $724.44 |
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 $602.56 Median $870.96 Typical High $1,174.90 | Professional | None | $602.56 | $870.96 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,288.25 Typical High $1,737.80 | Professional | 50 · Both sides | $912.01 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $549.54 Typical High $741.31 | Professional | 62 · Two surgeons | $380.19 | $549.54 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $7,244.36 | Facility | None | $707.95 | $707.95 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,168.69 Typical High $7,762.47 | Facility | None | $707.95 | $4,168.69 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $5,888.44 | Professional | None | $676.08 | $851.14 | $5,888.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,584.89 Median $6,606.93 Typical High $10,471.29 | Facility | None | $1,584.89 | $6,606.93 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $616.60 Median $1,000.00 Typical High $1,412.54 | Professional | None | $616.60 | $1,000.00 | $1,412.54 |
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 $724.44 Typical High $1,202.26 | Professional | None | $537.03 | $724.44 | $1,202.26 |
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 $295.12 Median $309.03 Typical High $338.84 | Professional | 52 · Reduced service | $295.12 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $123.03 Typical High $134.90 | Professional | 53 · Discontinued | $117.49 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $457.09 Typical High $512.86 | Professional | 54 · Surgery only | $446.68 | $457.09 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $91.20 Typical High $102.33 | Professional | 55 · Aftercare only | $89.13 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $61.66 Typical High $67.61 | Professional | 56 · Pre-op care only | $58.88 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $426.58 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $416.87 | $426.58 | $478.63 |
Where Indiana sits
The same service costs 4.8 times more in Alaska 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
AK $10,454MT $2,169
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.