How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,122 to $24,547Professionalmedian $603 · 10th to 90th $501 to $871
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 $575.44 Median $691.83 Typical High $17,378.01 | Facility | None | $575.44 | $691.83 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $776.25 | Professional | None | $549.54 | $549.54 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $645.65 | Professional | None | $302.00 | $302.00 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,905.46 Median $10,232.93 Typical High $28,183.83 | Facility | None | $1,905.46 | $10,232.93 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $741.31 | Professional | None | $501.19 | $660.69 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,000.00 Typical High $1,122.02 | Professional | 50 · Both sides | $741.31 | $1,000.00 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $416.87 Typical High $478.63 | Professional | 62 · Two surgeons | $316.23 | $416.87 | $478.63 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $107.15 Typical High $138.04 | Professional | 80 · Assistant surgeon | $79.43 | $107.15 | $138.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $93.33 Typical High $104.71 | Professional | AS · PA/NP assist | $69.18 | $93.33 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $5,888.44 | Facility | None | $575.44 | $575.44 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $4,466.84 Typical High $6,606.93 | Facility | None | $1,230.27 | $4,466.84 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,071.52 | Professional | None | $537.03 | $630.96 | $1,071.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,513.56 Median $6,025.60 Typical High $8,511.38 | Facility | None | $1,513.56 | $6,025.60 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $954.99 | Professional | None | $616.60 | $794.33 | $954.99 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,011.87 | $14,454.40 |
United Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $870.96 | Professional | None | $467.74 | $588.84 | $870.96 |
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 $275.42 Median $275.42 Typical High $371.54 | Professional | 52 · Reduced service | $275.42 | $275.42 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $151.36 | Professional | 53 · Discontinued | $109.65 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $562.34 | Professional | 54 · Surgery only | $407.38 | $407.38 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $112.20 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $74.13 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $524.81 |
Where Indiana sits
The same service costs 6.0 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 $11,096MT $1,846
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.