How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,698 to $28,840Professionalmedian $1,288 · 10th to 90th $891 to $1,995
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 $1,000.00 Median $5,011.87 Typical High $17,782.79 | Facility | None | $1,000.00 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,288.25 | Professional | None | $912.01 | $1,000.00 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $14,454.40 Typical High $33,113.11 | Facility | None | $2,041.74 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,479.11 Typical High $1,778.28 | Professional | None | $891.25 | $1,479.11 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $2,187.76 Typical High $2,754.23 | Professional | 50 · Both sides | $1,348.96 | $2,187.76 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $933.25 Typical High $1,148.15 | Professional | 62 · Two surgeons | $562.34 | $933.25 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $234.42 Typical High $316.23 | Professional | 80 · Assistant surgeon | $144.54 | $234.42 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $204.17 Typical High $257.04 | Professional | AS · PA/NP assist | $125.89 | $204.17 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $7,244.36 | Facility | None | $1,096.48 | $1,096.48 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $5,248.07 Typical High $7,943.28 | Facility | None | $1,230.27 | $5,248.07 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $7,079.46 | Professional | None | $1,096.48 | $1,318.26 | $7,079.46 |
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 $1,071.52 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,479.11 | $2,089.30 |
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 $851.14 Median $1,148.15 Typical High $1,905.46 | Professional | None | $851.14 | $1,148.15 | $1,905.46 |
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 $457.09 Median $489.78 Typical High $549.54 | Professional | 52 · Reduced service | $457.09 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $199.53 Typical High $218.78 | Professional | 53 · Discontinued | $181.97 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $831.76 | Professional | 54 · Surgery only | $676.08 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $165.96 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $100.00 Typical High $109.65 | Professional | 56 · Pre-op care only | $91.20 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $691.83 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $630.96 | $691.83 | $776.25 |
Where Indiana sits
The same service costs 4.2 times more in Colorado 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
CO $14,362MT $3,396
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.