How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,047 to $15,849Professionalmedian $1,380 · 10th to 90th $955 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 $1,047.13 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,047.13 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,258.93 | Professional | None | $954.99 | $1,047.13 | $1,258.93 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $1,412.54 Typical High $1,412.54 | Professional | None | $707.95 | $1,412.54 | $1,412.54 |
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 $954.99 Median $1,584.89 Typical High $1,905.46 | Professional | None | $954.99 | $1,584.89 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $2,344.23 Typical High $2,951.21 | Professional | 50 · Both sides | $1,412.54 | $2,344.23 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $1,000.00 Typical High $1,230.27 | Professional | 62 · Two surgeons | $602.56 | $1,000.00 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $251.19 Typical High $338.84 | Professional | 80 · Assistant surgeon | $151.36 | $251.19 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $218.78 Typical High $275.42 | Professional | AS · PA/NP assist | $131.83 | $218.78 | $275.42 |
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 $676.08 Median $6,165.95 Typical High $10,471.29 | Facility | None | $676.08 | $6,165.95 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $7,585.78 | Professional | None | $1,148.15 | $1,412.54 | $7,585.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,398.83 Typical High $11,481.54 | Facility | None | $912.01 | $2,398.83 | $11,481.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,548.82 | $2,187.76 |
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 $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 $776.25 Typical High $870.96 | Professional | 54 · Surgery only | $724.44 | $776.25 | $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 $724.44 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $676.08 | $724.44 | $812.83 |
Where Indiana sits
The same service costs 5.1 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 $14,343KY $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.