How much rates vary
Facilitymedian $3,715 · 10th to 90th $631 to $14,125Professionalmedian $437 · 10th to 90th $324 to $776
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 $323.59 Median $3,467.37 Typical High $7,244.36 | Facility | None | $323.59 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $524.81 | Professional | None | $323.59 | $426.58 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $7,413.10 Typical High $17,378.01 | Facility | None | $741.31 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $537.03 | Professional | None | $302.00 | $398.11 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $602.56 Typical High $831.76 | Professional | 50 · Both sides | $446.68 | $602.56 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $63.10 Typical High $95.50 | Professional | 80 · Assistant surgeon | $47.86 | $63.10 | $95.50 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $54.95 Typical High $77.62 | Professional | AS · PA/NP assist | $41.69 | $54.95 | $77.62 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $3,235.94 | Facility | None | $346.74 | $346.74 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,995.26 Typical High $3,467.37 | Facility | None | $457.09 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $891.25 | Professional | None | $363.08 | $575.44 | $891.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $5,248.07 | Facility | None | $912.01 | $2,290.87 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $371.54 Median $660.69 Typical High $1,000.00 | Professional | None | $371.54 | $660.69 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $933.25 | Professional | None | $331.13 | $524.81 | $933.25 |
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 $162.18 Median $208.93 Typical High $263.03 | Professional | 52 · Reduced service | $162.18 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $83.18 Typical High $104.71 | Professional | 53 · Discontinued | $64.57 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $316.23 Typical High $398.11 | Professional | 54 · Surgery only | $245.47 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $63.10 Typical High $79.43 | Professional | 55 · Aftercare only | $48.98 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $41.69 Typical High $52.48 | Professional | 56 · Pre-op care only | $32.36 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $295.12 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $229.09 | $295.12 | $371.54 |
Where Indiana sits
The same service costs 4.4 times more in Colorado 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
CO $6,451MT $1,460
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.