How much rates vary
Facilitymedian $7,413 · 10th to 90th $891 to $28,840Professionalmedian $813 · 10th to 90th $589 to $1,202
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 $630.96 Median $812.83 Typical High $11,220.18 | Facility | None | $630.96 | $812.83 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $870.96 | Professional | None | $575.44 | $630.96 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $588.84 Typical High $588.84 | Professional | None | $112.20 | $588.84 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,230.27 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,122.02 | Professional | None | $588.84 | $870.96 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,318.26 Typical High $1,737.80 | Professional | 50 · Both sides | $870.96 | $1,318.26 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $549.54 Typical High $724.44 | Professional | 62 · Two surgeons | $363.08 | $549.54 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $141.25 Typical High $190.55 | Professional | 80 · Assistant surgeon | $93.33 | $141.25 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $123.03 Typical High $162.18 | Professional | AS · PA/NP assist | $81.28 | $123.03 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $9,332.54 | Facility | None | $691.83 | $691.83 | $9,332.54 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,248.07 Typical High $9,772.37 | Facility | None | $645.65 | $5,248.07 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $4,570.88 | Professional | None | $676.08 | $851.14 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,778.28 Median $9,549.93 Typical High $11,748.98 | Facility | None | $1,778.28 | $9,549.93 | $11,748.98 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,348.96 | Professional | None | $691.83 | $977.24 | $1,348.96 |
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 $537.03 Median $707.95 Typical High $1,174.90 | Professional | None | $537.03 | $707.95 | $1,174.90 |
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 $288.40 Median $316.23 Typical High $346.74 | Professional | 52 · Reduced service | $288.40 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $114.82 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $93.33 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $57.54 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $436.52 | $478.63 |
Where Indiana sits
The same service costs 6.4 times more in Colorado 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
CO $13,816MT $2,168
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.