How much rates vary
Facilitymedian $7,244 · 10th to 90th $692 to $41,687Professionalmedian $3,981 · 10th to 90th $2,951 to $5,888
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 $3,981.07 Typical High $5,011.87 | Facility | None | $2,344.23 | $3,981.07 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $3,630.78 Median $3,981.07 Typical High $4,466.84 | Professional | None | $3,630.78 | $3,981.07 | $4,466.84 |
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 $2,951.21 Median $3,981.07 Typical High $5,754.40 | Professional | None | $2,951.21 | $3,981.07 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,862.09 Median $2,511.89 Typical High $3,630.78 | Professional | 62 · Two surgeons | $1,862.09 | $2,511.89 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $645.65 Typical High $954.99 | Professional | 80 · Assistant surgeon | $478.63 | $645.65 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $416.87 Median $562.34 Typical High $794.33 | Professional | AS · PA/NP assist | $416.87 | $562.34 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,691.53 Typical High $7,413.10 | Facility | None | $562.34 | $2,691.53 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $4,168.69 Typical High $5,888.44 | Professional | None | $2,630.27 | $4,168.69 | $5,888.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $4,466.84 Typical High $9,120.11 | Facility | None | $912.01 | $4,466.84 | $9,120.11 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3,630.78 Median $4,365.16 Typical High $5,888.44 | Professional | None | $3,630.78 | $4,365.16 | $5,888.44 |
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 $3,162.28 Median $4,677.35 Typical High $6,760.83 | Professional | None | $3,162.28 | $4,677.35 | $6,760.83 |
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 $1,819.70 Median $1,995.26 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,819.70 | $1,995.26 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $794.33 Typical High $891.25 | Professional | 53 · Discontinued | $724.44 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $3,019.95 Typical High $3,388.44 | Professional | 54 · Surgery only | $2,691.53 | $3,019.95 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $602.56 Typical High $676.08 | Professional | 55 · Aftercare only | $549.54 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $398.11 Typical High $446.68 | Professional | 56 · Pre-op care only | $363.08 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,818.38 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,818.38 | $3,162.28 |
Where Indiana sits
The same service costs 6.7 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 $26,148WA $3,907
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.