How much rates vary
Facilitymedian $3,981 · 10th to 90th $724 to $14,125Professionalmedian $832 · 10th to 90th $575 to $1,288
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 $616.60 Median $5,011.87 Typical High $7,244.36 | Facility | None | $616.60 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $724.44 | Professional | None | $575.44 | $616.60 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,413.10 Typical High $17,378.01 | Facility | None | $758.58 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $977.24 Typical High $1,258.93 | Professional | None | $562.34 | $977.24 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,479.11 Typical High $1,862.09 | Professional | 50 · Both sides | $851.14 | $1,479.11 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $616.60 Typical High $776.25 | Professional | 62 · Two surgeons | $354.81 | $616.60 | $776.25 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $3,235.94 | Facility | None | $676.08 | $676.08 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,995.26 Typical High $3,467.37 | Facility | None | $562.34 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $6,025.60 | Professional | None | $676.08 | $851.14 | $6,025.60 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $4,677.35 | Facility | None | $912.01 | $2,454.71 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,348.96 | Professional | None | $676.08 | $933.25 | $1,348.96 |
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 $537.03 Median $724.44 Typical High $1,230.27 | Professional | None | $537.03 | $724.44 | $1,230.27 |
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 $281.84 Median $302.00 Typical High $331.13 | Professional | 52 · Reduced service | $281.84 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $131.83 | Professional | 53 · Discontinued | $112.20 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $489.78 | Professional | 54 · Surgery only | $416.87 | $457.09 | $489.78 |
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 $56.23 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $56.23 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $467.74 |
Where Indiana sits
The same service costs 3.5 times more in Wisconsin than in Hawaii. 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
WI $7,283HI $2,091
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.