How much rates vary
Facilitymedian $6,918 · 10th to 90th $912 to $28,840Professionalmedian $661 · 10th to 90th $479 to $1,047
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 $512.86 Median $5,011.87 Typical High $11,220.18 | Facility | None | $512.86 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $575.44 | Professional | None | $467.74 | $512.86 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,230.27 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $794.33 Typical High $954.99 | Professional | None | $478.63 | $794.33 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $1,174.90 Typical High $1,445.44 | Professional | 50 · Both sides | $707.95 | $1,174.90 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $125.89 Typical High $169.82 | Professional | 80 · Assistant surgeon | $75.86 | $125.89 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $109.65 Typical High $134.90 | Professional | AS · PA/NP assist | $66.07 | $109.65 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $7,244.36 | Facility | None | $562.34 | $562.34 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $4,168.69 Typical High $7,762.47 | Facility | None | $575.44 | $4,168.69 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $4,466.84 | Professional | None | $537.03 | $630.96 | $4,466.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $5,248.07 Typical High $10,471.29 | Facility | None | $912.01 | $5,248.07 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,071.52 | Professional | None | $575.44 | $758.58 | $1,071.52 |
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 $436.52 Median $575.44 Typical High $954.99 | Professional | None | $436.52 | $575.44 | $954.99 |
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 $234.42 Median $251.19 Typical High $281.84 | Professional | 52 · Reduced service | $234.42 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $102.33 Typical High $112.20 | Professional | 53 · Discontinued | $93.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $416.87 | Professional | 54 · Surgery only | $346.74 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $51.29 Typical High $56.23 | Professional | 56 · Pre-op care only | $46.77 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $389.05 |
Where Indiana sits
The same service costs 7.9 times more in Colorado 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
CO $13,941MT $1,762
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.