How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,047 to $14,125Professionalmedian $1,000 · 10th to 90th $776 to $1,549
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 $831.76 Median $5,011.87 Typical High $14,125.38 | Facility | None | $831.76 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $954.99 | Professional | None | $758.58 | $831.76 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,348.96 | Professional | None | $776.25 | $1,000.00 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $158.49 Typical High $223.87 | Professional | 80 · Assistant surgeon | $125.89 | $158.49 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $138.04 Typical High $190.55 | Professional | AS · PA/NP assist | $109.65 | $138.04 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $3,235.94 | Facility | None | $912.01 | $912.01 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,454.71 Typical High $3,548.13 | Facility | None | $776.25 | $2,454.71 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $6,918.31 | Professional | None | $891.25 | $1,122.02 | $6,918.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,511.89 Typical High $4,677.35 | Facility | None | $912.01 | $2,511.89 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,819.70 | Professional | None | $831.76 | $1,258.93 | $1,819.70 |
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 $707.95 Median $933.25 Typical High $1,584.89 | Professional | None | $707.95 | $933.25 | $1,584.89 |
7 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 $380.19 Median $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $380.19 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $151.36 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $691.83 | Professional | 54 · Surgery only | $562.34 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $138.04 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $645.65 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $776.25 |
Where Indiana sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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 $7,993MD $2,690
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.