How much rates vary
Facilitymedian $6,310 · 10th to 90th $692 to $41,687Professionalmedian $2,512 · 10th to 90th $1,585 to $3,715
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 $2,041.74 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,041.74 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $2,041.74 Typical High $2,290.87 | Professional | None | $1,862.09 | $2,041.74 | $2,290.87 |
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 $1,584.89 Median $2,818.38 Typical High $3,801.89 | Professional | None | $1,584.89 | $2,818.38 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,778.28 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,000.00 | $1,778.28 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $457.09 Typical High $676.08 | Professional | 80 · Assistant surgeon | $251.19 | $457.09 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $398.11 Typical High $537.03 | Professional | AS · PA/NP assist | $218.78 | $398.11 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,089.30 Typical High $4,073.80 | Facility | None | $562.34 | $2,089.30 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,398.83 Typical High $3,801.89 | Professional | None | $1,819.70 | $2,398.83 | $3,801.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,398.83 Typical High $4,786.30 | Facility | None | $912.01 | $2,398.83 | $4,786.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,905.46 | $2,290.87 | $3,019.95 |
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 $1,737.80 Median $2,511.89 Typical High $3,548.13 | Professional | None | $1,737.80 | $2,511.89 | $3,548.13 |
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 $933.25 Median $1,023.29 Typical High $1,148.15 | Professional | 52 · Reduced service | $933.25 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $407.38 Typical High $457.09 | Professional | 53 · Discontinued | $371.54 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,548.82 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,380.38 | $1,548.82 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $309.03 Typical High $346.74 | Professional | 55 · Aftercare only | $281.84 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $204.17 Typical High $229.09 | Professional | 56 · Pre-op care only | $186.21 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,445.44 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,445.44 | $1,621.81 |
Where Indiana sits
The same service costs 7.9 times more in Alabama 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
AL $20,238WA $2,549
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.