How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,072 to $17,378Professionalmedian $1,318 · 10th to 90th $955 to $1,995
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 $1,047.13 Median $5,011.87 Typical High $15,488.17 | Facility | None | $1,047.13 | $5,011.87 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,288.25 | Professional | None | $954.99 | $1,047.13 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $1,412.54 | Professional | None | $954.99 | $1,412.54 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $8,317.64 Typical High $17,782.79 | Facility | None | $1,288.25 | $8,317.64 | $17,782.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $1,862.09 | Professional | None | $954.99 | $1,445.44 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $2,187.76 Typical High $2,818.38 | Professional | 50 · Both sides | $1,412.54 | $2,187.76 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $912.01 Typical High $1,202.26 | Professional | 62 · Two surgeons | $602.56 | $912.01 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $234.42 Typical High $316.23 | Professional | 80 · Assistant surgeon | $151.36 | $234.42 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $204.17 Typical High $263.03 | Professional | AS · PA/NP assist | $131.83 | $204.17 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $13,182.57 Typical High $18,620.87 | Facility | None | $645.65 | $13,182.57 | $18,620.87 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $6,918.31 | Professional | None | $1,122.02 | $1,348.96 | $6,918.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,398.83 Typical High $21,877.62 | Facility | None | $912.01 | $2,398.83 | $21,877.62 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,548.82 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,248.07 Typical High $14,791.08 | Facility | None | $1,258.93 | $5,248.07 | $14,791.08 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,995.26 | Professional | None | $912.01 | $1,202.26 | $1,995.26 |
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 $478.63 Median $524.81 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $208.93 Typical High $234.42 | Professional | 53 · Discontinued | $190.55 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $794.33 Typical High $870.96 | Professional | 54 · Surgery only | $724.44 | $794.33 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $158.49 Typical High $173.78 | Professional | 55 · Aftercare only | $144.54 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $104.71 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $741.31 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $676.08 | $741.31 | $812.83 |
Where Indiana sits
The same service costs 10.4 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 $29,118KY $2,808
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.