How much rates vary
Facilitymedian $13,804 · 10th to 90th $1,413 to $39,811Professionalmedian $1,905 · 10th to 90th $1,288 to $2,692
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 $1,318.26 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,412.54 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,513.56 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,258.93 | $2,041.74 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $3,019.95 Typical High $3,801.89 | Professional | 50 · Both sides | $1,905.46 | $3,019.95 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $323.59 Typical High $436.52 | Professional | 80 · Assistant surgeon | $204.17 | $323.59 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $281.84 Typical High $354.81 | Professional | AS · PA/NP assist | $177.83 | $281.84 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $18,620.87 | Facility | None | $1,584.89 | $1,584.89 | $18,620.87 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $10,715.19 Typical High $18,197.01 | Facility | None | $691.83 | $10,715.19 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $6,760.83 | Professional | None | $1,513.56 | $1,949.84 | $6,760.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $18,620.87 Typical High $23,988.33 | Facility | None | $2,089.30 | $18,620.87 | $23,988.33 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,513.56 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,513.56 | $2,137.96 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $8,912.51 Typical High $16,218.10 | Facility | None | $1,621.81 | $8,912.51 | $16,218.10 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,258.93 | $1,737.80 | $2,884.03 |
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 $660.69 Median $707.95 Typical High $794.33 | Professional | 52 · Reduced service | $660.69 | $707.95 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $316.23 | Professional | 53 · Discontinued | $263.03 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,071.52 Typical High $1,174.90 | Professional | 54 · Surgery only | $977.24 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $213.80 Typical High $234.42 | Professional | 55 · Aftercare only | $194.98 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $158.49 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,000.00 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $912.01 | $1,000.00 | $1,096.48 |
Where Indiana sits
The same service costs 6.5 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 $24,363KY $3,770
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.