How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,096 to $28,840Professionalmedian $1,023 · 10th to 90th $708 to $1,585
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 $851.14 Median $977.24 Typical High $16,595.87 | Facility | None | $851.14 | $977.24 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,023.29 | Professional | None | $691.83 | $758.58 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $14,454.40 Typical High $33,113.11 | Facility | None | $2,238.72 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,445.44 | Professional | None | $707.95 | $1,202.26 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,778.28 Typical High $2,238.72 | Professional | 50 · Both sides | $1,047.13 | $1,778.28 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $758.58 Typical High $954.99 | Professional | 62 · Two surgeons | $446.68 | $758.58 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $190.55 Typical High $257.04 | Professional | 80 · Assistant surgeon | $112.20 | $190.55 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $165.96 Typical High $208.93 | Professional | AS · PA/NP assist | $97.72 | $165.96 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $7,244.36 | Facility | None | $831.76 | $831.76 | $7,244.36 |
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 $831.76 Median $1,096.48 Typical High $6,025.60 | Professional | None | $831.76 | $1,096.48 | $6,025.60 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $7,585.78 Typical High $10,471.29 | Facility | None | $2,089.30 | $7,585.78 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,621.81 | Professional | None | $851.14 | $1,174.90 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,677.35 | $12,022.64 |
United Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,479.11 | Professional | None | $660.69 | $891.25 | $1,479.11 |
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 $346.74 Median $380.19 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $151.36 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $575.44 Typical High $630.96 | Professional | 54 · Surgery only | $524.81 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $85.11 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $537.03 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $489.78 | $537.03 | $588.84 |
Where Indiana sits
The same service costs 5.9 times more in Colorado than in West Virginia. 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 $14,031WV $2,390
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.