How much rates vary
Facilitymedian $2,818 · 10th to 90th $537 to $8,318Professionalmedian $525 · 10th to 90th $427 to $813
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 $588.84 Median $3,467.37 Typical High $5,011.87 | Facility | None | $588.84 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $691.83 | Professional | None | $524.81 | $588.84 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $776.25 | Professional | None | $426.58 | $524.81 | $776.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $331.13 Typical High $489.78 | Professional | 62 · Two surgeons | $269.15 | $331.13 | $489.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $85.11 Typical High $131.83 | Professional | 80 · Assistant surgeon | $67.61 | $85.11 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $74.13 Typical High $107.15 | Professional | AS · PA/NP assist | $58.88 | $74.13 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,995.26 Typical High $3,467.37 | Facility | None | $562.34 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $977.24 | Professional | None | $436.52 | $588.84 | $977.24 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $4,570.88 | Facility | None | $912.01 | $2,290.87 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $870.96 | Professional | None | $524.81 | $660.69 | $870.96 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $1,000.00 | Professional | None | $446.68 | $676.08 | $1,000.00 |
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 $263.03 Median $295.12 Typical High $338.84 | Professional | 52 · Reduced service | $263.03 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $117.49 Typical High $134.90 | Professional | 53 · Discontinued | $104.71 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $436.52 Typical High $501.19 | Professional | 54 · Surgery only | $389.05 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $89.13 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $58.88 Typical High $67.61 | Professional | 56 · Pre-op care only | $52.48 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $363.08 | $407.38 | $467.74 |
Where Indiana sits
The same service costs 4.9 times more in Alaska than in West Virginia. 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 $5,557WV $1,144
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.