How much rates vary
Facilitymedian $4,074 · 10th to 90th $871 to $14,125Professionalmedian $794 · 10th to 90th $550 to $1,148
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 $707.95 Median $758.58 Typical High $11,220.18 | Facility | None | $707.95 | $758.58 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $676.08 | Professional | None | $549.54 | $602.56 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,071.52 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $1,023.29 | Professional | None | $549.54 | $812.83 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,202.26 Typical High $1,584.89 | Professional | 50 · Both sides | $831.76 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $128.82 Typical High $177.83 | Professional | 80 · Assistant surgeon | $89.13 | $128.82 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $112.20 Typical High $147.91 | Professional | AS · PA/NP assist | $77.62 | $112.20 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $3,235.94 | Facility | None | $660.69 | $660.69 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,344.23 Typical High $3,548.13 | Facility | None | $630.96 | $2,344.23 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $4,466.84 | Professional | None | $645.65 | $812.83 | $4,466.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $4,677.35 | Facility | None | $912.01 | $2,454.71 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,258.93 | Professional | None | $645.65 | $912.01 | $1,258.93 |
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 $512.86 Median $691.83 Typical High $1,148.15 | Professional | None | $512.86 | $691.83 | $1,148.15 |
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 $275.42 Median $302.00 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $489.78 | Professional | 54 · Surgery only | $416.87 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $91.20 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $60.26 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $457.09 |
Where Indiana sits
The same service costs 3.7 times more in Wisconsin 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
WI $7,647MT $2,070
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.