How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,000 to $15,136Professionalmedian $1,047 · 10th to 90th $708 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 $776.25 Median $3,467.37 Typical High $5,011.87 | Facility | None | $776.25 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $891.25 | Professional | None | $707.95 | $776.25 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,202.26 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,202.26 Typical High $1,445.44 | Professional | None | $691.83 | $1,202.26 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,778.28 Typical High $2,238.72 | Professional | 50 · Both sides | $1,023.29 | $1,778.28 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $758.58 Typical High $933.25 | Professional | 62 · Two surgeons | $436.52 | $758.58 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $190.55 Typical High $257.04 | Professional | 80 · Assistant surgeon | $109.65 | $190.55 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $165.96 Typical High $208.93 | Professional | AS · PA/NP assist | $95.50 | $165.96 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,737.80 | Facility | None | $851.14 | $1,174.90 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,454.71 Typical High $3,548.13 | Facility | None | $645.65 | $2,454.71 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $6,165.95 | Professional | None | $870.96 | $1,122.02 | $6,165.95 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $9,120.11 | Facility | None | $912.01 | $2,089.30 | $9,120.11 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,698.24 | Professional | None | $831.76 | $1,148.15 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $1,548.82 | Professional | None | $691.83 | $954.99 | $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 $354.81 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $354.81 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $141.25 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $524.81 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $104.71 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $70.79 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $489.78 | $549.54 | $616.60 |
Where Indiana sits
The same service costs 5.0 times more in Alabama than in Kentucky. 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
AL $11,256KY $2,261
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.