How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,445 to $28,840Professionalmedian $1,445 · 10th to 90th $1,072 to $2,138
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 $1,174.90 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,174.90 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,174.90 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,778.28 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,445.44 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $912.01 Typical High $1,230.27 | Professional | 62 · Two surgeons | $676.08 | $912.01 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $234.42 Typical High $316.23 | Professional | 80 · Assistant surgeon | $173.78 | $234.42 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $204.17 Typical High $275.42 | Professional | AS · PA/NP assist | $151.36 | $204.17 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Facility | None | $9,332.54 | $9,332.54 | $9,332.54 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $4,786.30 Typical High $7,943.28 | Facility | None | $891.25 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $7,585.78 | Professional | None | $1,258.93 | $1,513.56 | $7,585.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $8,317.64 Typical High $13,182.57 | Facility | None | $2,089.30 | $8,317.64 | $13,182.57 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,202.26 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,778.28 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,380.38 | $2,290.87 |
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 $549.54 Median $588.84 Typical High $660.69 | Professional | 52 · Reduced service | $549.54 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $263.03 | Professional | 53 · Discontinued | $218.78 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $891.25 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $891.25 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $177.83 Typical High $194.98 | Professional | 55 · Aftercare only | $162.18 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $117.49 Typical High $131.83 | Professional | 56 · Pre-op care only | $109.65 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $831.76 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $831.76 | $912.01 |
Where Indiana sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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
CO $14,661HI $3,664
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.