How much rates vary
Facilitymedian $5,012 · 10th to 90th $813 to $19,055Professionalmedian $794 · 10th to 90th $676 to $1,122
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 $794.33 Median $5,011.87 Typical High $7,244.36 | Facility | None | $794.33 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,122.02 | Professional | None | $758.58 | $794.33 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $10,964.78 Typical High $22,908.68 | Facility | None | $794.33 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $933.25 | Professional | None | $630.96 | $794.33 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $501.19 Typical High $588.84 | Professional | 62 · Two surgeons | $398.11 | $501.19 | $588.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $125.89 Typical High $165.96 | Professional | 80 · Assistant surgeon | $102.33 | $125.89 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $112.20 Typical High $131.83 | Professional | AS · PA/NP assist | $89.13 | $112.20 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $6,025.60 | Facility | None | $794.33 | $794.33 | $6,025.60 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $3,467.37 Typical High $6,456.54 | Facility | None | $562.34 | $3,467.37 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,479.11 | Professional | None | $707.95 | $851.14 | $1,479.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,348.96 Median $6,165.95 Typical High $8,511.38 | Facility | None | $1,348.96 | $6,165.95 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,412.54 | Professional | None | $851.14 | $1,096.48 | $1,412.54 |
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 $676.08 Median $831.76 Typical High $1,258.93 | Professional | None | $676.08 | $831.76 | $1,258.93 |
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 $398.11 Typical High $524.81 | Professional | 52 · Reduced service | $380.19 | $398.11 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $208.93 | Professional | 53 · Discontinued | $151.36 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $588.84 Typical High $794.33 | Professional | 54 · Surgery only | $575.44 | $588.84 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $117.49 Typical High $158.49 | Professional | 55 · Aftercare only | $114.82 | $117.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $104.71 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $549.54 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $537.03 | $549.54 | $741.31 |
Where Indiana sits
The same service costs 4.0 times more in Alaska than in Delaware. 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 $9,177DE $2,272
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.