How much rates vary
Facilitymedian $11,220 · 10th to 90th $955 to $38,019Professionalmedian $708 · 10th to 90th $537 to $1,072
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 $870.96 Typical High $14,125.38 | Facility | None | $691.83 | $870.96 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $741.31 | Professional | None | $537.03 | $575.44 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
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 $501.19 Median $707.95 Typical High $977.24 | Professional | None | $501.19 | $707.95 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,047.13 Typical High $1,445.44 | Professional | 50 · Both sides | $758.58 | $1,047.13 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $446.68 Typical High $602.56 | Professional | 62 · Two surgeons | $316.23 | $446.68 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $112.20 Typical High $158.49 | Professional | 80 · Assistant surgeon | $85.11 | $112.20 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $97.72 Typical High $134.90 | Professional | AS · PA/NP assist | $75.86 | $97.72 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $17,782.79 | Facility | None | $630.96 | $630.96 | $17,782.79 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $12,302.69 Typical High $20,892.96 | Facility | None | $776.25 | $12,302.69 | $20,892.96 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $4,466.84 | Professional | None | $630.96 | $794.33 | $4,466.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $13,182.57 Typical High $21,877.62 | Facility | None | $912.01 | $13,182.57 | $21,877.62 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,258.93 | Professional | None | $645.65 | $870.96 | $1,258.93 |
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 $501.19 Median $660.69 Typical High $1,096.48 | Professional | None | $501.19 | $660.69 | $1,096.48 |
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 $263.03 Median $288.40 Typical High $309.03 | Professional | 52 · Reduced service | $263.03 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $114.82 Typical High $123.03 | Professional | 53 · Discontinued | $104.71 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $426.58 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $91.20 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $57.54 Typical High $61.66 | Professional | 56 · Pre-op care only | $52.48 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $398.11 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $398.11 | $426.58 |
Where Indiana sits
The same service costs 10.1 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 $19,890MT $1,977
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.