How much rates vary
Facilitymedian $11,220 · 10th to 90th $1,175 to $39,811Professionalmedian $1,072 · 10th to 90th $759 to $1,622
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 $831.76 Median $5,011.87 Typical High $14,125.38 | Facility | None | $831.76 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,071.52 | Professional | None | $758.58 | $831.76 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $20,892.96 Typical High $45,708.82 | Facility | None | $1,412.54 | $20,892.96 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $1,513.56 | Professional | None | $758.58 | $1,174.90 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,778.28 Typical High $2,290.87 | Professional | 50 · Both sides | $1,148.15 | $1,778.28 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $741.31 Typical High $954.99 | Professional | 62 · Two surgeons | $478.63 | $741.31 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $190.55 Typical High $257.04 | Professional | 80 · Assistant surgeon | $123.03 | $190.55 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $165.96 Typical High $213.80 | Professional | AS · PA/NP assist | $107.15 | $165.96 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $18,620.87 | Facility | None | $912.01 | $912.01 | $18,620.87 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $11,481.54 Typical High $19,054.61 | Facility | None | $776.25 | $11,481.54 | $19,054.61 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $5,754.40 | Professional | None | $912.01 | $1,096.48 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $13,489.63 Typical High $22,387.21 | Facility | None | $912.01 | $13,489.63 | $22,387.21 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,737.80 | Professional | None | $912.01 | $1,258.93 | $1,737.80 |
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 $724.44 Median $954.99 Typical High $1,584.89 | Professional | None | $724.44 | $954.99 | $1,584.89 |
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 $380.19 Median $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $380.19 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $151.36 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $691.83 | Professional | 54 · Surgery only | $575.44 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $645.65 |
Where Indiana sits
The same service costs 6.8 times more in Alaska 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
AK $19,480MT $2,858
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.