How much rates vary
Facilitymedian $4,074 · 10th to 90th $891 to $14,125Professionalmedian $617 · 10th to 90th $468 to $933
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 $489.78 Median $5,011.87 Typical High $11,220.18 | Facility | None | $489.78 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $630.96 | Professional | None | $446.68 | $489.78 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,071.52 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $831.76 | Professional | None | $467.74 | $660.69 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $1,000.00 Typical High $1,318.26 | Professional | 50 · Both sides | $691.83 | $1,000.00 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $416.87 Typical High $549.54 | Professional | 62 · Two surgeons | $295.12 | $416.87 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $107.15 Typical High $144.54 | Professional | 80 · Assistant surgeon | $74.13 | $107.15 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $93.33 Typical High $123.03 | Professional | AS · PA/NP assist | $64.57 | $93.33 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $3,235.94 | Facility | None | $537.03 | $537.03 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,995.26 Typical High $3,467.37 | Facility | None | $575.44 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $3,467.37 | Professional | None | $512.86 | $616.60 | $3,467.37 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $4,677.35 | Facility | None | $912.01 | $2,454.71 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,047.13 | Professional | None | $549.54 | $741.31 | $1,047.13 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,365.16 Typical High $9,120.11 | Facility | None | $870.96 | $4,365.16 | $9,120.11 |
United Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $933.25 | Professional | None | $426.58 | $562.34 | $933.25 |
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 $223.87 Median $245.47 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $371.54 Typical High $407.38 | Professional | 54 · Surgery only | $331.13 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $74.13 Typical High $81.28 | Professional | 55 · Aftercare only | $66.07 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $346.74 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $309.03 | $346.74 | $380.19 |
Where Indiana sits
The same service costs 4.5 times more in Connecticut 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
CT $7,632MT $1,703
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.