How much rates vary
Facilitymedian $8,913 · 10th to 90th $1,000 to $28,184Professionalmedian $912 · 10th to 90th $661 to $1,413
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 $758.58 Median $933.25 Typical High $14,125.38 | Facility | None | $758.58 | $933.25 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $794.33 | Professional | None | $660.69 | $724.44 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $14,125.38 Typical High $33,113.11 | Facility | None | $1,479.11 | $14,125.38 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,348.96 | Professional | None | $676.08 | $1,071.52 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,621.81 Typical High $1,995.26 | Professional | 50 · Both sides | $1,000.00 | $1,621.81 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $676.08 Typical High $851.14 | Professional | 62 · Two surgeons | $426.58 | $676.08 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $169.82 Typical High $229.09 | Professional | 80 · Assistant surgeon | $107.15 | $169.82 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $151.36 Typical High $186.21 | Professional | AS · PA/NP assist | $93.33 | $151.36 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $9,772.37 | Facility | None | $794.33 | $794.33 | $9,772.37 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $6,165.95 Typical High $10,964.78 | Facility | None | $776.25 | $6,165.95 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $5,128.61 | Professional | None | $776.25 | $912.01 | $5,128.61 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,041.74 Median $10,232.93 Typical High $13,182.57 | Facility | None | $2,041.74 | $10,232.93 | $13,182.57 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,548.82 | Professional | None | $812.83 | $1,122.02 | $1,548.82 |
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 $630.96 Median $851.14 Typical High $1,380.38 | Professional | None | $630.96 | $851.14 | $1,380.38 |
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 $331.13 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $331.13 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $131.83 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $501.19 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $467.74 | $512.86 | $562.34 |
Where Indiana sits
The same service costs 5.9 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 $14,644MT $2,489
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.