How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,000 to $25,704Professionalmedian $676 · 10th to 90th $550 to $1,000
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 $616.60 Median $5,011.87 Typical High $11,220.18 | Facility | None | $616.60 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $870.96 | Professional | None | $616.60 | $616.60 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $10,471.29 Typical High $28,840.32 | Facility | None | $1,698.24 | $10,471.29 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $870.96 | Professional | None | $549.54 | $758.58 | $870.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $478.63 Typical High $549.54 | Professional | 62 · Two surgeons | $346.74 | $478.63 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $120.23 Typical High $158.49 | Professional | 80 · Assistant surgeon | $87.10 | $120.23 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $107.15 Typical High $120.23 | Professional | AS · PA/NP assist | $77.62 | $107.15 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
CareSource Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,467.37 Typical High $6,456.54 | Facility | None | $707.95 | $3,467.37 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,202.26 | Professional | None | $602.56 | $691.83 | $1,202.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,388.44 Typical High $8,511.38 | Facility | None | $954.99 | $3,388.44 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,096.48 | Professional | None | $676.08 | $891.25 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $1,000.00 | Professional | None | $549.54 | $660.69 | $1,000.00 |
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 $309.03 Median $309.03 Typical High $416.87 | Professional | 52 · Reduced service | $309.03 | $309.03 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | 53 · Discontinued | $123.03 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $630.96 | Professional | 54 · Surgery only | $457.09 | $457.09 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $85.11 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $588.84 |
Where Indiana sits
The same service costs 5.4 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 $11,084MT $2,070
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.