How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,122 to $15,849Professionalmedian $1,660 · 10th to 90th $1,047 to $2,818
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 $1,380.38 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,380.38 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $2,089.30 | Professional | None | $1,737.80 | $1,905.46 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,230.27 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,230.27 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,862.09 Typical High $2,630.27 | Professional | 50 · Both sides | $1,584.89 | $1,862.09 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $776.25 Typical High $1,096.48 | Professional | 62 · Two surgeons | $660.69 | $776.25 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $199.53 Typical High $295.12 | Professional | 80 · Assistant surgeon | $169.82 | $199.53 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $173.78 Typical High $245.47 | Professional | AS · PA/NP assist | $147.91 | $173.78 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,265.80 Typical High $7,762.47 | Facility | None | $676.08 | $4,265.80 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $8,912.51 | Professional | None | $1,148.15 | $1,995.26 | $8,912.51 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $4,168.69 Typical High $17,782.79 | Facility | None | $912.01 | $4,168.69 | $17,782.79 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,698.24 Median $2,754.23 Typical High $4,073.80 | Professional | None | $1,698.24 | $2,754.23 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,949.84 Typical High $3,630.78 | Professional | None | $1,023.29 | $1,949.84 | $3,630.78 |
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 $870.96 Median $954.99 Typical High $1,047.13 | Professional | 52 · Reduced service | $870.96 | $954.99 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $380.19 Typical High $416.87 | Professional | 53 · Discontinued | $346.74 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,412.54 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,318.26 | $1,412.54 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $281.84 Typical High $316.23 | Professional | 55 · Aftercare only | $263.03 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $190.55 Typical High $208.93 | Professional | 56 · Pre-op care only | $173.78 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,318.26 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,318.26 | $1,479.11 |
Where Indiana sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $18,090KY $3,723
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.