How much rates vary
Facilitymedian $5,623 · 10th to 90th $708 to $28,840Professionalmedian $661 · 10th to 90th $417 to $1,000
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 $446.68 Median $5,011.87 Typical High $7,244.36 | Facility | None | $446.68 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $602.56 | Professional | None | $416.87 | $446.68 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $398.11 | Professional | None | $309.03 | $398.11 | $398.11 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $31.62 Typical High $50.12 | Professional | 80 · Assistant surgeon | $31.62 | $31.62 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $14,454.40 Typical High $33,113.11 | Facility | None | $758.58 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $776.25 Typical High $1,023.29 | Professional | None | $416.87 | $776.25 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $489.78 Typical High $660.69 | Professional | 62 · Two surgeons | $263.03 | $489.78 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $123.03 Typical High $173.78 | Professional | 80 · Assistant surgeon | $66.07 | $123.03 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $107.15 Typical High $144.54 | Professional | AS · PA/NP assist | $58.88 | $107.15 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $7,244.36 | Facility | None | $489.78 | $489.78 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $4,168.69 Typical High $7,762.47 | Facility | None | $501.19 | $4,168.69 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $4,677.35 | Professional | None | $489.78 | $741.31 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,258.93 Median $6,606.93 Typical High $10,471.29 | Facility | None | $1,258.93 | $6,606.93 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $977.24 | Professional | None | $501.19 | $691.83 | $977.24 |
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 $380.19 Median $512.86 Typical High $891.25 | Professional | None | $380.19 | $512.86 | $891.25 |
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 $204.17 Median $223.87 Typical High $234.42 | Professional | 52 · Reduced service | $204.17 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $89.13 Typical High $93.33 | Professional | 53 · Discontinued | $81.28 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $46.77 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $309.03 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $309.03 | $331.13 |
Where Indiana sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.