How much rates vary
Facilitymedian $8,128 · 10th to 90th $977 to $28,840Professionalmedian $1,122 · 10th to 90th $741 to $1,778
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 $812.83 Median $1,047.13 Typical High $11,220.18 | Facility | None | $812.83 | $1,047.13 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,122.02 | Professional | None | $707.95 | $812.83 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $831.76 Typical High $1,288.25 | Professional | None | $100.00 | $831.76 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,348.96 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,548.82 Typical High $1,862.09 | Professional | None | $758.58 | $1,548.82 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $2,344.23 Typical High $2,884.03 | Professional | 50 · Both sides | $1,148.15 | $2,344.23 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $977.24 Typical High $1,202.26 | Professional | 62 · Two surgeons | $478.63 | $977.24 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $245.47 Typical High $331.13 | Professional | 80 · Assistant surgeon | $123.03 | $245.47 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $218.78 Typical High $269.15 | Professional | AS · PA/NP assist | $107.15 | $218.78 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $9,549.93 | Facility | None | $891.25 | $891.25 | $9,549.93 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $6,165.95 Typical High $10,471.29 | Facility | None | $630.96 | $6,165.95 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $5,754.40 | Professional | None | $870.96 | $1,071.52 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,995.26 Median $9,772.37 Typical High $12,022.64 | Facility | None | $1,995.26 | $9,772.37 | $12,022.64 |
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 $5,248.07 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,248.07 | $14,454.40 |
United Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,548.82 | Professional | None | $691.83 | $912.01 | $1,548.82 |
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 $371.54 Median $407.38 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $660.69 | Professional | 54 · Surgery only | $549.54 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $616.60 |
Where Indiana sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.