How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,023 to $14,454Professionalmedian $759 · 10th to 90th $537 to $1,122
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 $602.56 Median $5,011.87 Typical High $14,125.38 | Facility | None | $602.56 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $812.83 | Professional | None | $549.54 | $602.56 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $331.13 | Professional | None | $45.71 | $45.71 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,071.52 | Professional | None | $562.34 | $851.14 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,258.93 Typical High $1,659.59 | Professional | 50 · Both sides | $831.76 | $1,258.93 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $537.03 Typical High $707.95 | Professional | 62 · Two surgeons | $354.81 | $537.03 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $134.90 Typical High $181.97 | Professional | 80 · Assistant surgeon | $89.13 | $134.90 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $117.49 Typical High $154.88 | Professional | AS · PA/NP assist | $77.62 | $117.49 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $9,332.54 | Facility | None | $660.69 | $660.69 | $9,332.54 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $6,165.95 Typical High $11,481.54 | Facility | None | $707.95 | $6,165.95 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $4,168.69 | Professional | None | $645.65 | $794.33 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,584.89 Median $8,511.38 Typical High $13,182.57 | Facility | None | $1,584.89 | $8,511.38 | $13,182.57 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,288.25 | Professional | None | $676.08 | $933.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,148.15 | Professional | None | $512.86 | $691.83 | $1,148.15 |
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 $275.42 Median $302.00 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $446.68 Typical High $501.19 | Professional | 54 · Surgery only | $416.87 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $91.20 Typical High $100.00 | Professional | 55 · Aftercare only | $83.18 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $60.26 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $416.87 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $389.05 | $416.87 | $467.74 |
Where Indiana sits
The same service costs 5.4 times more in Alaska than in Montana. 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 $11,142MT $2,070
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.