How much rates vary
Facilitymedian $7,586 · 10th to 90th $676 to $43,652Professionalmedian $3,388 · 10th to 90th $2,630 to $5,248
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 $5,011.87 Typical High $5,011.87 | Facility | None | $2,344.23 | $5,011.87 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,467.37 Typical High $4,466.84 | Professional | None | $3,162.28 | $3,467.37 | $4,466.84 |
Ambetter Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,168.69 | $4,168.69 | $4,168.69 |
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 $2,630.27 Median $3,388.44 Typical High $4,786.30 | Professional | None | $2,630.27 | $3,388.44 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $2,137.96 Typical High $3,019.95 | Professional | 62 · Two surgeons | $1,659.59 | $2,137.96 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $537.03 Typical High $831.76 | Professional | 80 · Assistant surgeon | $416.87 | $537.03 | $831.76 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $478.63 Typical High $676.08 | Professional | AS · PA/NP assist | $371.54 | $478.63 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $2,951.21 Median $3,801.89 Typical High $6,456.54 | Professional | None | $2,951.21 | $3,801.89 | $6,456.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,981.07 Typical High $7,943.28 | Facility | None | $912.01 | $3,981.07 | $7,943.28 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $5,128.61 | Professional | None | $3,235.94 | $3,801.89 | $5,128.61 |
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 $2,884.03 Median $4,168.69 Typical High $5,888.44 | Professional | None | $2,884.03 | $4,168.69 | $5,888.44 |
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 $1,584.89 Median $1,737.80 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,584.89 | $1,737.80 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $691.83 Typical High $776.25 | Professional | 53 · Discontinued | $630.96 | $691.83 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,630.27 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,344.23 | $2,630.27 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $524.81 Typical High $588.84 | Professional | 55 · Aftercare only | $478.63 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $346.74 Typical High $389.05 | Professional | 56 · Pre-op care only | $316.23 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,454.71 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,454.71 | $2,691.53 |
Where Indiana sits
The same service costs 6.6 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 $24,325WA $3,677
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.