How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,175 to $25,119Professionalmedian $813 · 10th to 90th $562 to $1,148
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 $588.84 Median $3,548.13 Typical High $14,125.38 | Facility | None | $588.84 | $3,548.13 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $812.83 | Professional | None | $588.84 | $588.84 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $10,232.93 Typical High $28,183.83 | Facility | None | $1,412.54 | $10,232.93 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $1,122.02 | Professional | None | $549.54 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $524.81 Typical High $707.95 | Professional | 62 · Two surgeons | $338.84 | $524.81 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $131.83 Typical High $186.21 | Professional | 80 · Assistant surgeon | $87.10 | $131.83 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $114.82 Typical High $154.88 | Professional | AS · PA/NP assist | $75.86 | $114.82 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $5,888.44 | Facility | None | $660.69 | $660.69 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,890.45 Typical High $6,606.93 | Facility | None | $776.25 | $3,890.45 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,288.25 | Professional | None | $602.56 | $794.33 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,659.59 Median $5,754.40 Typical High $8,511.38 | Facility | None | $1,659.59 | $5,754.40 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,202.26 | Professional | None | $676.08 | $977.24 | $1,202.26 |
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 $575.44 Median $758.58 Typical High $1,202.26 | Professional | None | $575.44 | $758.58 | $1,202.26 |
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 $295.12 Median $295.12 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $295.12 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $154.88 | Professional | 53 · Discontinued | $120.23 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $588.84 | Professional | 54 · Surgery only | $446.68 | $446.68 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $549.54 |
Where Indiana sits
The same service costs 5.1 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 $10,170MT $2,000
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.