How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,072 to $28,840Professionalmedian $977 · 10th to 90th $776 to $1,445
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 $724.44 Median $831.76 Typical High $912.01 | Professional | None | $724.44 | $831.76 | $912.01 |
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 $776.25 Median $977.24 Typical High $1,288.25 | Professional | None | $776.25 | $977.24 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $616.60 Typical High $831.76 | Professional | 62 · Two surgeons | $489.78 | $616.60 | $831.76 |
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 $186.21 | Professional | AS · PA/NP assist | $109.65 | $138.04 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $9,120.11 | Facility | None | $870.96 | $870.96 | $9,120.11 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $5,370.32 Typical High $10,000.00 | Facility | None | $794.33 | $5,370.32 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $6,165.95 | Professional | None | $851.14 | $1,071.52 | $6,165.95 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $6,918.31 Typical High $11,748.98 | Facility | None | $912.01 | $6,918.31 | $11,748.98 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $776.25 Median $1,258.93 Typical High $1,778.28 | Professional | None | $776.25 | $1,258.93 | $1,778.28 |
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 $676.08 Median $891.25 Typical High $1,513.56 | Professional | None | $676.08 | $891.25 | $1,513.56 |
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 $363.08 Median $407.38 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $165.96 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $83.18 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $630.96 |
Where Indiana sits
The same service costs 4.5 times more in Alaska 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
AK $12,963MT $2,892
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.