How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,175 to $14,125Professionalmedian $759 · 10th to 90th $631 to $1,072
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 $691.83 Median $5,011.87 Typical High $14,125.38 | Facility | None | $691.83 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $954.99 | Professional | None | $691.83 | $691.83 | $954.99 |
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 $616.60 Median $758.58 Typical High $870.96 | Professional | None | $616.60 | $758.58 | $870.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,148.15 Typical High $1,318.26 | Professional | 50 · Both sides | $912.01 | $1,148.15 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $478.63 Typical High $549.54 | Professional | 62 · Two surgeons | $380.19 | $478.63 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $123.03 Typical High $162.18 | Professional | 80 · Assistant surgeon | $97.72 | $123.03 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $107.15 Typical High $123.03 | Professional | AS · PA/NP assist | $85.11 | $107.15 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $3,467.37 | Facility | None | $741.31 | $741.31 | $3,467.37 |
CareSource Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,137.96 Typical High $4,570.88 | Facility | None | $794.33 | $2,137.96 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,412.54 | Professional | None | $691.83 | $776.25 | $1,412.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,737.80 Median $3,630.78 Typical High $5,754.40 | Facility | None | $1,737.80 | $3,630.78 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,230.27 | Professional | None | $776.25 | $1,000.00 | $1,230.27 |
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 $616.60 Median $758.58 Typical High $1,148.15 | Professional | None | $616.60 | $758.58 | $1,148.15 |
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 $346.74 Median $346.74 Typical High $478.63 | Professional | 52 · Reduced service | $346.74 | $346.74 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | 53 · Discontinued | $138.04 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $724.44 | Professional | 54 · Surgery only | $524.81 | $524.81 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $676.08 |
Where Indiana sits
The same service costs 3.2 times more in Wisconsin 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
WI $7,578MT $2,350
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.