How much rates vary
Facilitymedian $7,079 · 10th to 90th $676 to $43,652Professionalmedian $2,692 · 10th to 90th $2,042 to $4,169
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 $2,344.23 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,344.23 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,691.53 Typical High $3,019.95 | Professional | None | $2,454.71 | $2,691.53 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,445.44 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,691.53 Typical High $4,073.80 | Professional | None | $2,041.74 | $2,691.53 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,698.24 Typical High $2,570.40 | Professional | 62 · Two surgeons | $1,288.25 | $1,698.24 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $436.52 Typical High $660.69 | Professional | 80 · Assistant surgeon | $331.13 | $436.52 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $380.19 Typical High $575.44 | Professional | AS · PA/NP assist | $288.40 | $380.19 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,818.38 Typical High $5,011.87 | Professional | None | $2,187.76 | $2,818.38 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,090.30 Typical High $6,309.57 | Facility | None | $912.01 | $3,090.30 | $6,309.57 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $3,981.07 | Professional | None | $2,511.89 | $3,019.95 | $3,981.07 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $3,162.28 Typical High $4,570.88 | Professional | None | $2,137.96 | $3,162.28 | $4,570.88 |
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 $1,230.27 Median $1,348.96 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,230.27 | $1,348.96 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $537.03 Typical High $602.56 | Professional | 53 · Discontinued | $489.78 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,041.74 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,819.70 | $2,041.74 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $407.38 Typical High $457.09 | Professional | 55 · Aftercare only | $371.54 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $269.15 Typical High $302.00 | Professional | 56 · Pre-op care only | $245.47 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,905.46 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,905.46 | $2,137.96 |
Where Indiana sits
The same service costs 7.1 times more in Alaska than in Washington. 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 $21,795WA $3,065
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.