How much rates vary
Facilitymedian $6,761 · 10th to 90th $933 to $28,840Professionalmedian $851 · 10th to 90th $631 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 $691.83 Median $912.01 Typical High $11,481.54 | Facility | None | $691.83 | $912.01 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $912.01 | Professional | None | $630.96 | $691.83 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,479.11 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $1,258.93 | Professional | None | $645.65 | $954.99 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,412.54 Typical High $1,862.09 | Professional | 50 · Both sides | $977.24 | $1,412.54 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $602.56 Typical High $812.83 | Professional | 62 · Two surgeons | $407.38 | $602.56 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $151.36 Typical High $208.93 | Professional | 80 · Assistant surgeon | $104.71 | $151.36 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $131.83 Typical High $173.78 | Professional | AS · PA/NP assist | $91.20 | $131.83 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $7,244.36 | Facility | None | $758.58 | $758.58 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $7,943.28 | Facility | None | $776.25 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $5,128.61 | Professional | None | $741.31 | $954.99 | $5,128.61 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,949.84 Median $6,606.93 Typical High $10,471.29 | Facility | None | $1,949.84 | $6,606.93 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,479.11 | Professional | None | $776.25 | $1,071.52 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,318.26 | Professional | None | $602.56 | $794.33 | $1,318.26 |
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 $316.23 Median $346.74 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $524.81 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $489.78 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $489.78 | $524.81 |
Where Indiana sits
The same service costs 5.7 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 $13,613MT $2,377
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.