How much rates vary
Facilitymedian $4,677 · 10th to 90th $646 to $9,120Professionalmedian $1,122 · 10th to 90th $776 to $1,660
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 $1,174.90 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,174.90 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,174.90 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $5,370.32 Typical High $9,120.11 | Facility | None | $1,380.38 | $5,370.32 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,096.48 | Professional | None | $707.95 | $831.76 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $524.81 Typical High $691.83 | Professional | 62 · Two surgeons | $446.68 | $524.81 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $181.97 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $154.88 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,344.23 | Facility | None | $1,230.27 | $1,548.82 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
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 $1,047.13 Median $1,288.25 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,288.25 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,162.28 | Facility | None | $912.01 | $2,290.87 | $3,162.28 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,659.59 | $2,041.74 |
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 $1,230.27 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,230.27 | $1,905.46 |
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 $575.44 Typical High $794.33 | Professional | 52 · Reduced service | $575.44 | $575.44 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $323.59 | Professional | 53 · Discontinued | $234.42 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,202.26 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $239.88 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $1,122.02 |
Where Indiana sits
The same service costs 5.9 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 $10,682MD $1,821
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.