How much rates vary
Facilitymedian $3,715 · 10th to 90th $851 to $9,120Professionalmedian $437 · 10th to 90th $347 to $676
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 $436.52 Median $5,011.87 Typical High $11,220.18 | Facility | None | $436.52 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $537.03 | Professional | None | $436.52 | $436.52 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $575.44 | Professional | None | $346.74 | $416.87 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $616.60 Typical High $891.25 | Professional | 50 · Both sides | $524.81 | $616.60 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $56.23 Median $66.07 Typical High $100.00 | Professional | 80 · Assistant surgeon | $56.23 | $66.07 | $100.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $57.54 Typical High $83.18 | Professional | AS · PA/NP assist | $48.98 | $57.54 | $83.18 |
CareSource Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,348.96 Typical High $2,398.83 | Facility | None | $645.65 | $1,348.96 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $758.58 | Professional | None | $457.09 | $549.54 | $758.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,047.13 Median $1,905.46 Typical High $2,511.89 | Facility | None | $1,047.13 | $1,905.46 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $794.33 | Professional | None | $416.87 | $537.03 | $794.33 |
5 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 $218.78 Median $218.78 Typical High $251.19 | Professional | 52 · Reduced service | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | 53 · Discontinued | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $380.19 | Professional | 54 · Surgery only | $323.59 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $66.07 Typical High $75.86 | Professional | 55 · Aftercare only | $64.57 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $50.12 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $50.12 |
Where Indiana sits
The same service costs 5.4 times more in Oklahoma 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
OK $7,144MT $1,321
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.