How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,122 to $28,840Professionalmedian $1,000 · 10th to 90th $813 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 $851.14 Median $5,011.87 Typical High $14,125.38 | Facility | None | $851.14 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $954.99 | Professional | None | $758.58 | $851.14 | $954.99 |
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 $831.76 Median $1,000.00 Typical High $1,348.96 | Professional | None | $831.76 | $1,000.00 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $162.18 Typical High $229.09 | Professional | 80 · Assistant surgeon | $131.83 | $162.18 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $141.25 Typical High $190.55 | Professional | AS · PA/NP assist | $114.82 | $141.25 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $9,332.54 | Facility | None | $912.01 | $912.01 | $9,332.54 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $7,943.28 | Facility | None | $776.25 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $6,760.83 | Professional | None | $891.25 | $1,174.90 | $6,760.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $5,248.07 Typical High $10,471.29 | Facility | None | $912.01 | $5,248.07 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $812.83 Median $1,318.26 Typical High $1,862.09 | Professional | None | $812.83 | $1,318.26 | $1,862.09 |
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 $724.44 Median $933.25 Typical High $1,621.81 | Professional | None | $724.44 | $933.25 | $1,621.81 |
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 $380.19 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $380.19 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $173.78 Typical High $186.21 | Professional | 53 · Discontinued | $151.36 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $691.83 | Professional | 54 · Surgery only | $562.34 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $128.82 Typical High $138.04 | Professional | 55 · Aftercare only | $112.20 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $93.33 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $645.65 |
Where Indiana sits
The same service costs 4.2 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 $12,508MT $2,994
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.