How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,096 to $14,454Professionalmedian $1,349 · 10th to 90th $1,023 to $2,138
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 $1,479.11 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,479.11 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,479.11 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,202.26 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,202.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $1,148.15 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $194.98 Typical High $302.00 | Professional | 80 · Assistant surgeon | $162.18 | $194.98 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $169.82 Typical High $257.04 | Professional | AS · PA/NP assist | $144.54 | $169.82 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,168.69 Typical High $6,918.31 | Facility | None | $645.65 | $4,168.69 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,584.89 | $2,630.27 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,467.37 Typical High $7,943.28 | Facility | None | $954.99 | $3,467.37 | $7,943.28 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $2,187.76 | Professional | None | $1,348.96 | $1,659.59 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $4,168.69 Typical High $9,120.11 | Facility | None | $1,096.48 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,737.80 | $2,511.89 |
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 $676.08 Median $741.31 Typical High $831.76 | Professional | 52 · Reduced service | $676.08 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $295.12 Typical High $331.13 | Professional | 53 · Discontinued | $269.15 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,122.02 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,000.00 | $1,122.02 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $223.87 Typical High $251.19 | Professional | 55 · Aftercare only | $199.53 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $147.91 Typical High $165.96 | Professional | 56 · Pre-op care only | $134.90 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,174.90 |
Where Indiana sits
The same service costs 6.6 times more in Alabama 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
AL $18,462KY $2,797
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.