How much rates vary
Facilitymedian $7,413 · 10th to 90th $891 to $28,840Professionalmedian $776 · 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 $537.03 Median $588.84 Typical High $812.83 | Professional | None | $537.03 | $588.84 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
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 $549.54 Median $851.14 Typical High $1,096.48 | Professional | None | $549.54 | $851.14 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,288.25 Typical High $1,659.59 | Professional | 50 · Both sides | $812.83 | $1,288.25 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $537.03 Typical High $691.83 | Professional | 62 · Two surgeons | $346.74 | $537.03 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $138.04 Typical High $186.21 | Professional | 80 · Assistant surgeon | $87.10 | $138.04 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $120.23 Typical High $154.88 | Professional | AS · PA/NP assist | $75.86 | $120.23 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $9,120.11 | Facility | None | $645.65 | $645.65 | $9,120.11 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $5,248.07 Typical High $9,772.37 | Facility | None | $616.60 | $5,248.07 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $4,570.88 | Professional | None | $630.96 | $794.33 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,659.59 Median $9,549.93 Typical High $11,748.98 | Facility | None | $1,659.59 | $9,549.93 | $11,748.98 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,258.93 | Professional | None | $660.69 | $912.01 | $1,258.93 |
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 $501.19 Median $660.69 Typical High $1,122.02 | Professional | None | $501.19 | $660.69 | $1,122.02 |
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 $269.15 Median $295.12 Typical High $323.59 | Professional | 52 · Reduced service | $269.15 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $128.82 | Professional | 53 · Discontinued | $107.15 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $398.11 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $64.57 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $371.54 | $407.38 | $446.68 |
Where Indiana sits
The same service costs 6.8 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 $13,753MT $2,023
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.