How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,380 to $14,454Professionalmedian $631 · 10th to 90th $537 to $933
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 $602.56 Median $5,011.87 Typical High $14,125.38 | Facility | None | $602.56 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $851.14 | Professional | None | $602.56 | $616.60 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $7,585.78 Typical High $17,378.01 | Facility | None | $1,819.70 | $7,585.78 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $724.44 | Professional | None | $512.86 | $630.96 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $954.99 Typical High $1,122.02 | Professional | 50 · Both sides | $758.58 | $954.99 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $398.11 Typical High $467.74 | Professional | 62 · Two surgeons | $323.59 | $398.11 | $467.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $102.33 Typical High $134.90 | Professional | 80 · Assistant surgeon | $81.28 | $102.33 | $134.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $89.13 Typical High $104.71 | Professional | AS · PA/NP assist | $70.79 | $89.13 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $3,467.37 | Facility | None | $645.65 | $645.65 | $3,467.37 |
CareSource Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $2,691.53 Typical High $5,248.07 | Facility | None | $1,513.56 | $2,691.53 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $1,230.27 | Professional | None | $588.84 | $676.08 | $1,230.27 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,659.59 Median $3,630.78 Typical High $5,754.40 | Facility | None | $1,659.59 | $3,630.78 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,071.52 | Professional | None | $676.08 | $870.96 | $1,071.52 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,000.00 | Professional | None | $524.81 | $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 $302.00 Median $302.00 Typical High $416.87 | Professional | 52 · Reduced service | $302.00 | $302.00 | $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 $60.26 Median $60.26 Typical High $83.18 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $83.18 |
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 3.8 times more in Oklahoma 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
OK $7,804MT $2,047
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.