How much rates vary
Facilitymedian $4,074 · 10th to 90th $832 to $14,125Professionalmedian $525 · 10th to 90th $372 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 $426.58 Median $524.81 Typical High $11,220.18 | Facility | None | $426.58 | $524.81 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $524.81 | Professional | None | $363.08 | $389.05 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,071.52 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $707.95 | Professional | None | $380.19 | $562.34 | $707.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $239.88 Median $354.81 Typical High $467.74 | Professional | 62 · Two surgeons | $239.88 | $354.81 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $3,235.94 | Facility | None | $436.52 | $436.52 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,344.23 Typical High $3,548.13 | Facility | None | $630.96 | $2,344.23 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $3,311.31 | Professional | None | $426.58 | $537.03 | $3,311.31 |
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 $426.58 Median $602.56 Typical High $870.96 | Professional | None | $426.58 | $602.56 | $870.96 |
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 $346.74 Median $457.09 Typical High $758.58 | Professional | None | $346.74 | $457.09 | $758.58 |
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 $181.97 Median $194.98 Typical High $208.93 | Professional | 52 · Reduced service | $181.97 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $79.43 Typical High $83.18 | Professional | 53 · Discontinued | $72.44 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $295.12 Typical High $316.23 | Professional | 54 · Surgery only | $269.15 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $58.88 Typical High $63.10 | Professional | 55 · Aftercare only | $53.70 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.90 Typical High $41.69 | Professional | 56 · Pre-op care only | $36.31 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $275.42 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $251.19 | $275.42 | $295.12 |
Where Indiana sits
The same service costs 5.1 times more in Wisconsin 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
WI $7,097MT $1,384
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.