How much rates vary
Facilitymedian $8,318 · 10th to 90th $955 to $28,840Professionalmedian $891 · 10th to 90th $631 to $1,349
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 $707.95 Median $5,011.87 Typical High $11,220.18 | Facility | None | $707.95 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $831.76 | Professional | None | $630.96 | $707.95 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,230.27 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,258.93 | Professional | None | $630.96 | $1,000.00 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,513.56 Typical High $1,862.09 | Professional | 50 · Both sides | $933.25 | $1,513.56 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $630.96 Typical High $794.33 | Professional | 62 · Two surgeons | $398.11 | $630.96 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $158.49 Typical High $213.80 | Professional | 80 · Assistant surgeon | $100.00 | $158.49 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $141.25 Typical High $173.78 | Professional | AS · PA/NP assist | $87.10 | $141.25 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $9,772.37 | Facility | None | $758.58 | $758.58 | $9,772.37 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,495.41 Typical High $10,232.93 | Facility | None | $645.65 | $5,495.41 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $5,248.07 | Professional | None | $758.58 | $954.99 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $7,413.10 Typical High $12,302.69 | Facility | None | $912.01 | $7,413.10 | $12,302.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,479.11 | Professional | None | $758.58 | $1,023.29 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,348.96 | Professional | None | $616.60 | $812.83 | $1,348.96 |
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 $354.81 Typical High $389.05 | Professional | 52 · Reduced service | $316.23 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $125.89 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $467.74 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $104.71 Typical High $114.82 | Professional | 55 · Aftercare only | $93.33 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $70.79 Typical High $77.62 | Professional | 56 · Pre-op care only | $63.10 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $436.52 | $489.78 | $537.03 |
Where Indiana sits
The same service costs 6.0 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 $14,230MT $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.