How much rates vary
Facilitymedian $9,772 · 10th to 90th $1,230 to $28,840Professionalmedian $912 · 10th to 90th $617 to $1,349
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 $691.83 Median $5,011.87 Typical High $14,125.38 | Facility | None | $691.83 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $812.83 | Professional | None | $630.96 | $691.83 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,479.11 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $1,000.00 Typical High $1,230.27 | Professional | None | $616.60 | $1,000.00 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,513.56 Typical High $1,862.09 | Professional | 50 · Both sides | $933.25 | $1,513.56 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $630.96 Typical High $776.25 | Professional | 62 · Two surgeons | $389.05 | $630.96 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $158.49 Typical High $213.80 | Professional | 80 · Assistant surgeon | $100.00 | $158.49 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $141.25 Typical High $173.78 | Professional | AS · PA/NP assist | $87.10 | $141.25 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $10,000.00 | Facility | None | $758.58 | $758.58 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $6,606.93 Typical High $11,220.18 | Facility | None | $776.25 | $6,606.93 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $5,011.87 | Professional | None | $741.31 | $912.01 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,862.09 Median $10,232.93 Typical High $13,182.57 | Facility | None | $1,862.09 | $10,232.93 | $13,182.57 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,445.44 | Professional | None | $741.31 | $1,023.29 | $1,445.44 |
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 $588.84 Median $794.33 Typical High $1,318.26 | Professional | None | $588.84 | $794.33 | $1,318.26 |
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 $316.23 Median $338.84 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $562.34 | Professional | 54 · Surgery only | $467.74 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $74.13 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $524.81 |
Where Indiana sits
The same service costs 6.2 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 $14,513MT $2,350
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.