How much rates vary
Facilitymedian $3,467 · 10th to 90th $603 to $14,125Professionalmedian $490 · 10th to 90th $398 to $741
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 $416.87 Median $3,467.37 Typical High $5,623.41 | Facility | None | $416.87 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $537.03 | Professional | None | $416.87 | $446.68 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $7,413.10 Typical High $17,378.01 | Facility | None | $724.44 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $724.44 | Professional | None | $380.19 | $489.78 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $79.43 Typical High $123.03 | Professional | 80 · Assistant surgeon | $60.26 | $79.43 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $69.18 Typical High $102.33 | Professional | AS · PA/NP assist | $52.48 | $69.18 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $2,511.89 | Facility | None | $436.52 | $436.52 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,513.56 Typical High $2,630.27 | Facility | None | $426.58 | $1,513.56 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $724.44 | Professional | None | $436.52 | $537.03 | $724.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,096.48 Median $2,238.72 Typical High $4,168.69 | Facility | None | $1,096.48 | $2,238.72 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $851.14 | Professional | None | $446.68 | $562.34 | $851.14 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $812.83 | Professional | None | $398.11 | $524.81 | $812.83 |
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 $208.93 Median $223.87 Typical High $263.03 | Professional | 52 · Reduced service | $208.93 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $104.71 | Professional | 53 · Discontinued | $83.18 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $316.23 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $63.10 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $44.67 Typical High $52.48 | Professional | 56 · Pre-op care only | $41.69 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $295.12 | $316.23 | $371.54 |
Where Indiana sits
The same service costs 4.8 times more in Colorado than in North Dakota. 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
CO $6,549ND $1,369
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.