How much rates vary
Facilitymedian $2,570 · 10th to 90th $229 to $8,128Professionalmedian $162 · 10th to 90th $71 to $234
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 $74.13 Median $204.17 Typical High $5,011.87 | Facility | None | $74.13 | $204.17 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $144.54 Typical High $218.78 | Professional | None | $70.79 | $144.54 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $89.13 | Professional | None | $53.70 | $67.61 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $660.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $162.18 Typical High $218.78 | Professional | None | $77.62 | $162.18 | $218.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $239.88 Typical High $338.84 | Professional | 50 · Both sides | $117.49 | $239.88 | $338.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.98 Median $25.70 Typical High $38.90 | Professional | 80 · Assistant surgeon | $16.98 | $25.70 | $38.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $10.96 Median $22.39 Typical High $31.62 | Professional | AS · PA/NP assist | $10.96 | $22.39 | $31.62 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $2,511.89 | Facility | None | $75.86 | $75.86 | $2,511.89 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $218.78 | Professional | None | $154.88 | $181.97 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,659.59 Typical High $2,691.53 | Facility | None | $645.65 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $181.97 Typical High $263.03 | Professional | None | $81.28 | $181.97 | $263.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $199.53 Median $2,187.76 Typical High $4,168.69 | Facility | None | $199.53 | $2,187.76 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $83.18 Median $169.82 Typical High $338.84 | Professional | None | $83.18 | $169.82 | $338.84 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $4,677.35 | Facility | None | $512.86 | $2,089.30 | $4,677.35 |
United Setting Professional Modifier None Typical Low $77.62 Median $158.49 Typical High $302.00 | Professional | None | $77.62 | $158.49 | $302.00 |
5 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 $35.48 Median $72.44 Typical High $85.11 | Professional | 52 · Reduced service | $35.48 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $29.51 Typical High $33.88 | Professional | 53 · Discontinued | $14.13 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $109.65 Typical High $125.89 | Professional | 54 · Surgery only | $53.70 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $21.88 Typical High $25.12 | Professional | 55 · Aftercare only | $10.72 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $14.45 Typical High $16.98 | Professional | 56 · Pre-op care only | $7.08 | $14.45 | $16.98 |
Where Indiana sits
The same service costs 9.7 times more in Colorado than in Montana. 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
CO $4,351MT $447
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.