How much rates vary
Facilitymedian $5,495 · 10th to 90th $692 to $21,878Professionalmedian $1,479 · 10th to 90th $1,023 to $2,188
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 $1,412.54 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,412.54 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,412.54 | $1,584.89 |
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 $977.24 Median $1,479.11 Typical High $1,995.26 | Professional | None | $977.24 | $1,479.11 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $2,187.76 Typical High $2,951.21 | Professional | 50 · Both sides | $1,445.44 | $2,187.76 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $933.25 Typical High $1,258.93 | Professional | 62 · Two surgeons | $616.60 | $933.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $234.42 Typical High $354.81 | Professional | 80 · Assistant surgeon | $154.88 | $234.42 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $204.17 Typical High $275.42 | Professional | AS · PA/NP assist | $134.90 | $204.17 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,548.82 Typical High $2,691.53 | Facility | None | $575.44 | $1,548.82 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,621.81 | $2,511.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,019.95 | Facility | None | $912.01 | $2,290.87 | $3,019.95 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,479.11 | $2,041.74 |
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 $1,202.26 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,698.24 | $2,398.83 |
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 $602.56 Median $707.95 Typical High $794.33 | Professional | 52 · Reduced service | $602.56 | $707.95 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $281.84 Typical High $316.23 | Professional | 53 · Discontinued | $239.88 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,047.13 Typical High $1,174.90 | Professional | 54 · Surgery only | $891.25 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $208.93 Typical High $234.42 | Professional | 55 · Aftercare only | $177.83 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $141.25 Typical High $158.49 | Professional | 56 · Pre-op care only | $120.23 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $977.24 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $831.76 | $977.24 | $1,096.48 |
Where Indiana sits
The same service costs 6.4 times more in Alaska than in Maryland. 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 $12,091MD $1,881
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.