How much rates vary
Facilitymedian $2,692 · 10th to 90th $794 to $14,125Professionalmedian $1,288 · 10th to 90th $977 to $1,950
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 $1,230.27 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,230.27 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,230.27 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,981.07 Typical High $16,595.87 | Facility | None | $1,288.25 | $3,981.07 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,819.70 | Professional | None | $977.24 | $1,288.25 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $794.33 Typical High $1,148.15 | Professional | 62 · Two surgeons | $616.60 | $794.33 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $204.17 Typical High $309.03 | Professional | 80 · Assistant surgeon | $154.88 | $204.17 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $177.83 Typical High $251.19 | Professional | AS · PA/NP assist | $134.90 | $177.83 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,380.38 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $2,951.21 | Facility | None | $912.01 | $2,290.87 | $2,951.21 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,412.54 | $1,905.46 |
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 $1,023.29 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,479.11 | $2,089.30 |
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 $575.44 Median $616.60 Typical High $724.44 | Professional | 52 · Reduced service | $575.44 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $245.47 Typical High $288.40 | Professional | 53 · Discontinued | $229.09 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $933.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $123.03 Typical High $144.54 | Professional | 56 · Pre-op care only | $114.82 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $1,000.00 |
Where Indiana sits
The same service costs 9.9 times more in Alabama 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
AL $18,241MD $1,851
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.