How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,096 to $25,119Professionalmedian $912 · 10th to 90th $661 to $1,318
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 $758.58 Median $5,011.87 Typical High $7,244.36 | Facility | None | $758.58 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $812.83 | Professional | None | $758.58 | $758.58 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $12,022.64 Typical High $28,840.32 | Facility | None | $1,621.81 | $12,022.64 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,230.27 | Professional | None | $660.69 | $912.01 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,380.38 Typical High $1,862.09 | Professional | 50 · Both sides | $1,000.00 | $1,380.38 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $575.44 Typical High $776.25 | Professional | 62 · Two surgeons | $416.87 | $575.44 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $147.91 Typical High $208.93 | Professional | 80 · Assistant surgeon | $104.71 | $147.91 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $128.82 Typical High $173.78 | Professional | AS · PA/NP assist | $93.33 | $128.82 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $5,623.41 | Facility | None | $831.76 | $831.76 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,630.78 Typical High $6,165.95 | Facility | None | $549.54 | $3,630.78 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,548.82 | Professional | None | $794.33 | $977.24 | $1,548.82 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,258.93 Median $5,754.40 Typical High $9,549.93 | Facility | None | $1,258.93 | $5,754.40 | $9,549.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,584.89 | Professional | None | $812.83 | $1,047.13 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,513.56 | Professional | None | $645.65 | $912.01 | $1,513.56 |
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 $380.19 Median $380.19 Typical High $407.38 | Professional | 52 · Reduced service | $380.19 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $162.18 | Professional | 53 · Discontinued | $151.36 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $616.60 | Professional | 54 · Surgery only | $562.34 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $114.82 Typical High $123.03 | Professional | 55 · Aftercare only | $112.20 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $81.28 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $575.44 |
Where Indiana sits
The same service costs 6.6 times more in Colorado 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
CO $11,917WV $1,804
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.