How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,000 to $15,136Professionalmedian $1,905 · 10th to 90th $1,380 to $2,884
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 $1,412.54 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,412.54 | $1,513.56 | $1,737.80 |
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 $1,348.96 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,348.96 | $2,089.30 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $3,162.28 Typical High $4,073.80 | Professional | 50 · Both sides | $2,041.74 | $3,162.28 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,318.26 Typical High $1,737.80 | Professional | 62 · Two surgeons | $851.14 | $1,318.26 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $338.84 Typical High $457.09 | Professional | 80 · Assistant surgeon | $218.78 | $338.84 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $295.12 Typical High $380.19 | Professional | AS · PA/NP assist | $190.55 | $295.12 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,309.57 Typical High $10,715.19 | Facility | None | $645.65 | $6,309.57 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $10,000.00 | Professional | None | $1,659.59 | $1,995.26 | $10,000.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,481.54 | Facility | None | $912.01 | $3,388.44 | $11,481.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,621.81 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,621.81 | $2,290.87 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,778.28 | $2,951.21 |
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 $707.95 Median $758.58 Typical High $851.14 | Professional | 52 · Reduced service | $707.95 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $302.00 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,148.15 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,148.15 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $151.36 Typical High $169.82 | Professional | 56 · Pre-op care only | $141.25 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,071.52 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $1,071.52 | $1,174.90 |
Where Indiana sits
The same service costs 4.7 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 $16,761KY $3,604
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.