How much rates vary
Facilitymedian $7,762 · 10th to 90th $891 to $19,055Professionalmedian $1,660 · 10th to 90th $1,148 to $2,754
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 $1,949.84 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,949.84 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,737.80 | $1,949.84 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $10,964.78 Typical High $22,387.21 | Facility | None | $1,862.09 | $10,964.78 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,348.96 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $1,995.26 Typical High $3,090.30 | Professional | 50 · Both sides | $1,698.24 | $1,995.26 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $851.14 Typical High $1,318.26 | Professional | 62 · Two surgeons | $724.44 | $851.14 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $213.80 Typical High $338.84 | Professional | 80 · Assistant surgeon | $181.97 | $213.80 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $186.21 Typical High $288.40 | Professional | AS · PA/NP assist | $158.49 | $186.21 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,949.84 Typical High $3,548.13 | Facility | None | $562.34 | $1,949.84 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $3,388.44 | Professional | None | $1,621.81 | $2,041.74 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $4,466.84 | Facility | None | $912.01 | $2,290.87 | $4,466.84 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $2,818.38 | Professional | None | $1,737.80 | $2,137.96 | $2,818.38 |
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 $1,621.81 Median $2,290.87 Typical High $3,311.31 | Professional | None | $1,621.81 | $2,290.87 | $3,311.31 |
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 $870.96 Median $977.24 Typical High $1,096.48 | Professional | 52 · Reduced service | $870.96 | $977.24 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $389.05 Typical High $436.52 | Professional | 53 · Discontinued | $346.74 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,445.44 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,318.26 | $1,445.44 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $295.12 Typical High $323.59 | Professional | 55 · Aftercare only | $263.03 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $194.98 Typical High $218.78 | Professional | 56 · Pre-op care only | $173.78 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,348.96 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,348.96 | $1,513.56 |
Where Indiana sits
The same service costs 7.9 times more in Alabama 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
AL $19,273WA $2,428
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.