How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,047 to $13,490Professionalmedian $891 · 10th to 90th $589 to $1,820
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 $7,244.36 | Facility | None | $1,174.90 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,174.90 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $3,981.07 Typical High $15,135.61 | Facility | None | $1,380.38 | $3,981.07 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,047.13 | Professional | None | $588.84 | $691.83 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,023.29 Typical High $1,584.89 | Professional | 50 · Both sides | $870.96 | $1,023.29 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $436.52 Typical High $660.69 | Professional | 62 · Two surgeons | $371.54 | $436.52 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $3,235.94 | Facility | None | $1,288.25 | $1,288.25 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,187.76 Typical High $3,548.13 | Facility | None | $549.54 | $2,187.76 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,174.90 Typical High $5,495.41 | Professional | None | $660.69 | $1,174.90 | $5,495.41 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,584.89 Median $3,388.44 Typical High $5,248.07 | Facility | None | $1,584.89 | $3,388.44 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $870.96 Median $1,737.80 Typical High $2,454.71 | Professional | None | $870.96 | $1,737.80 | $2,454.71 |
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 $588.84 Median $1,122.02 Typical High $2,187.76 | Professional | None | $588.84 | $1,122.02 | $2,187.76 |
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 $537.03 Median $575.44 Typical High $645.65 | Professional | 52 · Reduced service | $537.03 | $575.44 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $234.42 Typical High $257.04 | Professional | 53 · Discontinued | $213.80 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $870.96 Typical High $954.99 | Professional | 54 · Surgery only | $794.33 | $870.96 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $190.55 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $117.49 Typical High $128.82 | Professional | 56 · Pre-op care only | $107.15 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $812.83 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $812.83 | $891.25 |
Where Indiana sits
The same service costs 3.7 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 $9,494KY $2,537
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.