How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,175 to $28,840Professionalmedian $977 · 10th to 90th $832 to $1,660
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 $977.24 Median $5,011.87 Typical High $14,125.38 | Facility | None | $977.24 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,122.02 | Professional | None | $870.96 | $977.24 | $1,122.02 |
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 $977.24 Typical High $1,288.25 | Professional | None | $831.76 | $977.24 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,479.11 Typical High $1,995.26 | Professional | 50 · Both sides | $1,258.93 | $1,479.11 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $154.88 Typical High $223.87 | Professional | 80 · Assistant surgeon | $131.83 | $154.88 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $138.04 Typical High $186.21 | Professional | AS · PA/NP assist | $117.49 | $138.04 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $7,244.36 | Facility | None | $1,047.13 | $1,047.13 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $4,786.30 Typical High $7,943.28 | Facility | None | $724.44 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $5,888.44 | Professional | None | $977.24 | $1,122.02 | $5,888.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,548.82 Median $6,606.93 Typical High $10,471.29 | Facility | None | $1,548.82 | $6,606.93 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $933.25 Median $1,513.56 Typical High $2,089.30 | Professional | None | $933.25 | $1,513.56 | $2,089.30 |
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 $812.83 Median $1,047.13 Typical High $1,778.28 | Professional | None | $812.83 | $1,047.13 | $1,778.28 |
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 $436.52 Median $489.78 Typical High $524.81 | Professional | 52 · Reduced service | $436.52 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $194.98 Typical High $208.93 | Professional | 53 · Discontinued | $173.78 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $645.65 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $147.91 Typical High $158.49 | Professional | 55 · Aftercare only | $131.83 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $97.72 Typical High $104.71 | Professional | 56 · Pre-op care only | $87.10 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $676.08 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $602.56 | $676.08 | $741.31 |
Where Indiana sits
The same service costs 3.9 times more in Alaska than in Delaware. 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 $12,209DE $3,093
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.