How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,175 to $19,498Professionalmedian $1,000 · 10th to 90th $759 to $1,514
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 $1,047.13 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,047.13 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,258.93 | Professional | None | $933.25 | $1,047.13 | $1,258.93 |
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 $724.44 Median $912.01 Typical High $1,380.38 | Professional | None | $724.44 | $912.01 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,348.96 Typical High $2,041.74 | Professional | 50 · Both sides | $1,122.02 | $1,348.96 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $575.44 Typical High $870.96 | Professional | 62 · Two surgeons | $467.74 | $575.44 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $144.54 Typical High $223.87 | Professional | 80 · Assistant surgeon | $120.23 | $144.54 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $125.89 Typical High $190.55 | Professional | AS · PA/NP assist | $104.71 | $125.89 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,168.69 Typical High $6,918.31 | Facility | None | $630.96 | $4,168.69 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,905.46 | Professional | None | $933.25 | $1,202.26 | $1,905.46 |
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 $933.25 Median $1,148.15 Typical High $1,513.56 | Professional | None | $933.25 | $1,148.15 | $1,513.56 |
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 $912.01 Median $1,288.25 Typical High $1,819.70 | Professional | None | $912.01 | $1,288.25 | $1,819.70 |
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 $467.74 Median $524.81 Typical High $575.44 | Professional | 52 · Reduced service | $467.74 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $208.93 Typical High $229.09 | Professional | 53 · Discontinued | $186.21 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $776.25 Typical High $870.96 | Professional | 54 · Surgery only | $707.95 | $776.25 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $154.88 Typical High $173.78 | Professional | 55 · Aftercare only | $141.25 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $104.71 Typical High $114.82 | Professional | 56 · Pre-op care only | $93.33 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $724.44 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $660.69 | $724.44 | $812.83 |
Where Indiana sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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 $11,128KY $2,365
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.