How much rates vary
Facilitymedian $4,074 · 10th to 90th $933 to $14,125Professionalmedian $1,023 · 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 $870.96 Median $5,011.87 Typical High $11,220.18 | Facility | None | $870.96 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $954.99 | Professional | None | $776.25 | $870.96 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,071.52 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,380.38 | Professional | None | $831.76 | $1,023.29 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $645.65 Typical High $870.96 | Professional | 62 · Two surgeons | $524.81 | $645.65 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $165.96 Typical High $234.42 | Professional | 80 · Assistant surgeon | $131.83 | $165.96 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $144.54 Typical High $194.98 | Professional | AS · PA/NP assist | $117.49 | $144.54 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $3,235.94 | Facility | None | $933.25 | $933.25 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,995.26 Typical High $3,467.37 | Facility | None | $645.65 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $6,025.60 | Professional | None | $912.01 | $1,122.02 | $6,025.60 |
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 $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 $1,584.89 | Professional | None | $724.44 | $933.25 | $1,584.89 |
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 $389.05 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $389.05 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $575.44 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $77.62 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $537.03 | $602.56 | $660.69 |
Where Indiana sits
The same service costs 3.1 times more in Alaska than in Hawaii. 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 $8,167HI $2,648
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.