How much rates vary
Facilitymedian $9,120 · 10th to 90th $1,288 to $25,704Professionalmedian $1,096 · 10th to 90th $813 to $1,585
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 $851.14 Median $5,011.87 Typical High $16,595.87 | Facility | None | $851.14 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,148.15 | Professional | None | $851.14 | $851.14 | $1,148.15 |
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 $776.25 Median $1,096.48 Typical High $1,479.11 | Professional | None | $776.25 | $1,096.48 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,659.59 Typical High $2,238.72 | Professional | 50 · Both sides | $1,148.15 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $691.83 Typical High $933.25 | Professional | 62 · Two surgeons | $489.78 | $691.83 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $177.83 Typical High $251.19 | Professional | 80 · Assistant surgeon | $123.03 | $177.83 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $154.88 Typical High $208.93 | Professional | AS · PA/NP assist | $107.15 | $154.88 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $10,964.78 | Facility | None | $891.25 | $6,606.93 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,698.24 | Professional | None | $851.14 | $1,122.02 | $1,698.24 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,388.44 Typical High $15,135.61 | Facility | None | $954.99 | $3,388.44 | $15,135.61 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $1,698.24 | Professional | None | $954.99 | $1,380.38 | $1,698.24 |
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 $870.96 Median $1,096.48 Typical High $1,737.80 | Professional | None | $870.96 | $1,096.48 | $1,737.80 |
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 $426.58 Median $426.58 Typical High $562.34 | Professional | 52 · Reduced service | $426.58 | $426.58 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $223.87 | Professional | 53 · Discontinued | $169.82 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $831.76 | Professional | 54 · Surgery only | $645.65 | $645.65 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $169.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $776.25 |
Where Indiana sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.