How much rates vary
Facilitymedian $18,197 · 10th to 90th $1,905 to $56,234Professionalmedian $2,188 · 10th to 90th $1,479 to $3,162
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 $1,621.81 Median $5,011.87 Typical High $17,782.79 | Facility | None | $1,621.81 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,621.81 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $38,018.94 Typical High $77,624.71 | Facility | None | $2,344.23 | $38,018.94 | $77,624.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $2,344.23 Typical High $2,884.03 | Professional | None | $1,445.44 | $2,344.23 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $3,548.13 Typical High $4,365.16 | Professional | 50 · Both sides | $2,187.76 | $3,548.13 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $371.54 Typical High $501.19 | Professional | 80 · Assistant surgeon | $229.09 | $371.54 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $331.13 Typical High $407.38 | Professional | AS · PA/NP assist | $204.17 | $331.13 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $28,183.83 | Facility | None | $1,819.70 | $1,819.70 | $28,183.83 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $18,620.87 Typical High $26,302.68 | Facility | None | $645.65 | $18,620.87 | $26,302.68 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $7,762.47 | Professional | None | $1,778.28 | $2,238.72 | $7,762.47 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $25,703.96 Typical High $33,884.42 | Facility | None | $2,089.30 | $25,703.96 | $33,884.42 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,737.80 Median $2,454.71 Typical High $3,311.31 | Professional | None | $1,737.80 | $2,454.71 | $3,311.31 |
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 $1,445.44 Median $1,995.26 Typical High $3,311.31 | Professional | None | $1,445.44 | $1,995.26 | $3,311.31 |
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 $758.58 Median $812.83 Typical High $912.01 | Professional | 52 · Reduced service | $758.58 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $323.59 Typical High $363.08 | Professional | 53 · Discontinued | $302.00 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,230.27 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,122.02 | $1,230.27 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $245.47 Typical High $269.15 | Professional | 55 · Aftercare only | $223.87 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $162.18 Typical High $181.97 | Professional | 56 · Pre-op care only | $151.36 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,148.15 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,148.15 | $1,258.93 |
Where Indiana sits
The same service costs 7.8 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 $31,233KY $3,989
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.