How much rates vary
Facilitymedian $4,074 · 10th to 90th $891 to $14,125Professionalmedian $676 · 10th to 90th $468 to $1,047
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 $489.78 Median $5,011.87 Typical High $11,220.18 | Facility | None | $489.78 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $562.34 | Professional | None | $457.09 | $489.78 | $562.34 |
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 $467.74 Median $758.58 Typical High $1,023.29 | Professional | None | $467.74 | $758.58 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $1,122.02 Typical High $1,513.56 | Professional | 50 · Both sides | $707.95 | $1,122.02 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $478.63 Typical High $645.65 | Professional | 62 · Two surgeons | $295.12 | $478.63 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $3,235.94 | Facility | None | $549.54 | $549.54 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,995.26 Typical High $3,467.37 | Facility | None | $575.44 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $5,370.32 | Professional | None | $562.34 | $776.25 | $5,370.32 |
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 $562.34 Median $776.25 Typical High $1,096.48 | Professional | None | $562.34 | $776.25 | $1,096.48 |
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 $436.52 Median $588.84 Typical High $1,000.00 | Professional | None | $436.52 | $588.84 | $1,000.00 |
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 $229.09 Median $245.47 Typical High $263.03 | Professional | 52 · Reduced service | $229.09 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $100.00 Typical High $107.15 | Professional | 53 · Discontinued | $91.20 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $371.54 Typical High $398.11 | Professional | 54 · Surgery only | $338.84 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $74.13 Typical High $79.43 | Professional | 55 · Aftercare only | $67.61 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $52.48 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $346.74 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $316.23 | $346.74 | $371.54 |
Where Indiana sits
The same service costs 4.3 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 $7,406MT $1,722
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.