How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,072 to $19,498Professionalmedian $708 · 10th to 90th $525 to $1,047
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 $660.69 Median $3,467.37 Typical High $5,011.87 | Facility | None | $660.69 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $851.14 | Professional | None | $602.56 | $660.69 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $11,481.54 Typical High $23,988.33 | Facility | None | $1,479.11 | $11,481.54 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $977.24 | Professional | None | $489.78 | $707.95 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,071.52 Typical High $1,479.11 | Professional | 50 · Both sides | $741.31 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $446.68 Typical High $616.60 | Professional | 62 · Two surgeons | $309.03 | $446.68 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $114.82 Typical High $169.82 | Professional | 80 · Assistant surgeon | $77.62 | $114.82 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $100.00 Typical High $138.04 | Professional | AS · PA/NP assist | $69.18 | $100.00 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,715.35 Typical High $6,760.83 | Facility | None | $602.56 | $3,715.35 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,230.27 | Professional | None | $575.44 | $776.25 | $1,230.27 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,162.28 Typical High $8,128.31 | Facility | None | $954.99 | $3,162.28 | $8,128.31 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $977.24 | Professional | None | $602.56 | $724.44 | $977.24 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,174.90 | Professional | None | $588.84 | $794.33 | $1,174.90 |
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 $302.00 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $302.00 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $120.23 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $501.19 Typical High $562.34 | Professional | 54 · Surgery only | $446.68 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $100.00 Typical High $112.20 | Professional | 55 · Aftercare only | $89.13 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $66.07 Typical High $74.13 | Professional | 56 · Pre-op care only | $60.26 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $467.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $416.87 | $467.74 | $524.81 |
Where Indiana sits
The same service costs 5.6 times more in Wisconsin 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
WI $10,313MT $1,845
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.