How much rates vary
Facilitymedian $3,236 · 10th to 90th $794 to $14,125Professionalmedian $1,230 · 10th to 90th $1,047 to $2,089
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 $1,230.27 Median $5,011.87 Typical High $11,220.18 | Facility | None | $1,230.27 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,202.26 | $1,230.27 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,047.13 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,230.27 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,862.09 Typical High $2,511.89 | Professional | 50 · Both sides | $1,513.56 | $1,862.09 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $776.25 Typical High $1,047.13 | Professional | 62 · Two surgeons | $630.96 | $776.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $199.53 Typical High $281.84 | Professional | 80 · Assistant surgeon | $162.18 | $199.53 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $173.78 Typical High $234.42 | Professional | AS · PA/NP assist | $141.25 | $173.78 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,511.89 | Facility | None | $1,445.44 | $1,445.44 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,862.09 Typical High $2,691.53 | Facility | None | $630.96 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $6,606.93 | Professional | None | $1,096.48 | $1,412.54 | $6,606.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,570.40 Typical High $4,168.69 | Facility | None | $912.01 | $2,570.40 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,258.93 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,949.84 | $2,691.53 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $2,344.23 | Professional | None | $977.24 | $1,348.96 | $2,344.23 |
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 $602.56 Median $616.60 Typical High $691.83 | Professional | 52 · Reduced service | $602.56 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $245.47 Typical High $281.84 | Professional | 53 · Discontinued | $239.88 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,047.13 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $186.21 Typical High $208.93 | Professional | 55 · Aftercare only | $181.97 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $123.03 Typical High $138.04 | Professional | 56 · Pre-op care only | $120.23 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $977.24 |
Where Indiana sits
The same service costs 3.7 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 $8,917DE $2,410
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.