How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,047 to $15,136Professionalmedian $1,380 · 10th to 90th $977 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 $1,071.52 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,071.52 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,230.27 | Professional | None | $1,000.00 | $1,071.52 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,548.82 Typical High $1,949.84 | Professional | None | $977.24 | $1,548.82 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $2,344.23 Typical High $2,951.21 | Professional | 50 · Both sides | $1,479.11 | $2,344.23 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $977.24 Typical High $1,230.27 | Professional | 62 · Two surgeons | $616.60 | $977.24 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $245.47 Typical High $331.13 | Professional | 80 · Assistant surgeon | $154.88 | $245.47 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $218.78 Typical High $275.42 | Professional | AS · PA/NP assist | $138.04 | $218.78 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,309.57 Typical High $10,471.29 | Facility | None | $645.65 | $6,309.57 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $7,413.10 | Professional | None | $1,174.90 | $1,412.54 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $11,481.54 | Facility | None | $912.01 | $2,454.71 | $11,481.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,174.90 | $1,621.81 | $2,290.87 |
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 $954.99 Median $1,258.93 Typical High $2,089.30 | Professional | None | $954.99 | $1,258.93 | $2,089.30 |
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 $501.19 Median $537.03 Typical High $602.56 | Professional | 52 · Reduced service | $501.19 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $239.88 | Professional | 53 · Discontinued | $199.53 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $912.01 | Professional | 54 · Surgery only | $741.31 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $181.97 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $120.23 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $851.14 |
Where Indiana sits
The same service costs 5.5 times more in Alaska than in Texas. 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 $14,559TX $2,668
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.