How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,122 to $15,136Professionalmedian $1,259 · 10th to 90th $1,000 to $2,188
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 $16,595.87 | Facility | None | $1,380.38 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,380.38 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,174.90 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,174.90 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,737.80 Typical High $2,344.23 | Professional | 50 · Both sides | $1,479.11 | $1,737.80 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $741.31 Typical High $1,000.00 | Professional | 62 · Two surgeons | $630.96 | $741.31 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $186.21 Typical High $263.03 | Professional | 80 · Assistant surgeon | $158.49 | $186.21 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $162.18 Typical High $218.78 | Professional | AS · PA/NP assist | $138.04 | $162.18 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,890.45 Typical High $7,762.47 | Facility | None | $691.83 | $3,890.45 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $6,606.93 | Professional | None | $1,023.29 | $1,548.82 | $6,606.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,981.07 Typical High $9,332.54 | Facility | None | $954.99 | $3,981.07 | $9,332.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,412.54 | $2,089.30 | $2,951.21 |
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 $891.25 Median $1,445.44 Typical High $2,630.27 | Professional | None | $891.25 | $1,445.44 | $2,630.27 |
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 $645.65 Median $691.83 Typical High $776.25 | Professional | 52 · Reduced service | $645.65 | $691.83 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $275.42 Typical High $309.03 | Professional | 53 · Discontinued | $257.04 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,047.13 Typical High $1,148.15 | Professional | 54 · Surgery only | $954.99 | $1,047.13 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $208.93 Typical High $229.09 | Professional | 55 · Aftercare only | $190.55 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $138.04 Typical High $154.88 | Professional | 56 · Pre-op care only | $128.82 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $977.24 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $891.25 | $977.24 | $1,071.52 |
Where Indiana sits
The same service costs 5.5 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 $15,938KY $2,890
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.