How much rates vary
Facilitymedian $11,220 · 10th to 90th $1,023 to $38,905Professionalmedian $1,047 · 10th to 90th $741 to $1,514
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 $812.83 Median $5,011.87 Typical High $11,220.18 | Facility | None | $812.83 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $912.01 | Professional | None | $741.31 | $812.83 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $20,892.96 Typical High $45,708.82 | Facility | None | $1,122.02 | $20,892.96 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $1,479.11 | Professional | None | $741.31 | $1,148.15 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,737.80 Typical High $2,187.76 | Professional | 50 · Both sides | $1,096.48 | $1,737.80 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $724.44 Typical High $933.25 | Professional | 62 · Two surgeons | $467.74 | $724.44 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $181.97 Typical High $245.47 | Professional | 80 · Assistant surgeon | $117.49 | $181.97 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $162.18 Typical High $204.17 | Professional | AS · PA/NP assist | $102.33 | $162.18 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $19,054.61 | Facility | None | $891.25 | $891.25 | $19,054.61 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $10,232.93 Typical High $19,054.61 | Facility | None | $645.65 | $10,232.93 | $19,054.61 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $5,888.44 | Professional | None | $870.96 | $1,096.48 | $5,888.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $17,378.01 Typical High $22,908.68 | Facility | None | $2,089.30 | $17,378.01 | $22,908.68 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,698.24 | Professional | None | $891.25 | $1,230.27 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,513.56 | Professional | None | $691.83 | $933.25 | $1,513.56 |
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 $371.54 Median $407.38 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $630.96 |
Where Indiana sits
The same service costs 7.5 times more in Alaska than in Hawaii. 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 $19,036HI $2,542
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.