How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,047 to $16,982Professionalmedian $977 · 10th to 90th $661 to $1,514
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 $707.95 Median $3,467.37 Typical High $5,011.87 | Facility | None | $707.95 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $954.99 | Professional | None | $660.69 | $707.95 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $977.24 | Professional | None | $851.14 | $977.24 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,148.15 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,122.02 Typical High $1,380.38 | Professional | None | $645.65 | $1,122.02 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,698.24 Typical High $2,089.30 | Professional | 50 · Both sides | $977.24 | $1,698.24 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $707.95 Typical High $891.25 | Professional | 62 · Two surgeons | $407.38 | $707.95 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $181.97 Typical High $245.47 | Professional | 80 · Assistant surgeon | $104.71 | $181.97 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $158.49 Typical High $194.98 | Professional | AS · PA/NP assist | $91.20 | $158.49 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,737.80 | Facility | None | $794.33 | $1,174.90 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,454.71 Typical High $3,548.13 | Facility | None | $645.65 | $2,454.71 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $5,888.44 | Professional | None | $794.33 | $1,047.13 | $5,888.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,041.74 Typical High $22,908.68 | Facility | None | $912.01 | $2,041.74 | $22,908.68 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,548.82 | Professional | None | $776.25 | $1,047.13 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $8,912.51 Typical High $16,218.10 | Facility | None | $1,621.81 | $8,912.51 | $16,218.10 |
United Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,445.44 | Professional | None | $645.65 | $870.96 | $1,445.44 |
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 $331.13 Median $354.81 Typical High $407.38 | Professional | 52 · Reduced service | $331.13 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $165.96 | Professional | 53 · Discontinued | $131.83 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $501.19 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $83.18 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $575.44 |
Where Indiana sits
The same service costs 4.3 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 $9,769TX $2,271
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.