How much rates vary
Facilitymedian $5,012 · 10th to 90th $912 to $19,055Professionalmedian $646 · 10th to 90th $427 to $955
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 $616.60 Median $707.95 Typical High $16,595.87 | Facility | None | $616.60 | $707.95 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $851.14 | Professional | None | $575.44 | $602.56 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $457.09 | Professional | None | $288.40 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $11,220.18 Typical High $22,908.68 | Facility | None | $1,513.56 | $11,220.18 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $776.25 | Professional | None | $426.58 | $630.96 | $776.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $398.11 Typical High $489.78 | Professional | 62 · Two surgeons | $269.15 | $398.11 | $489.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $102.33 Typical High $123.03 | Professional | 80 · Assistant surgeon | $69.18 | $102.33 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $89.13 Typical High $107.15 | Professional | AS · PA/NP assist | $60.26 | $89.13 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $4,570.88 | Facility | None | $630.96 | $630.96 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,311.31 Typical High $5,011.87 | Facility | None | $891.25 | $3,311.31 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $1,047.13 | Professional | None | $407.38 | $660.69 | $1,047.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,513.56 Median $4,786.30 Typical High $7,079.46 | Facility | None | $1,513.56 | $4,786.30 | $7,079.46 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,122.02 | Professional | None | $602.56 | $741.31 | $1,122.02 |
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 $501.19 Median $741.31 Typical High $1,096.48 | Professional | None | $501.19 | $741.31 | $1,096.48 |
7 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 $302.00 Typical High $363.08 | Professional | 52 · Reduced service | $275.42 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $144.54 | Professional | 53 · Discontinued | $109.65 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $537.03 | Professional | 54 · Surgery only | $416.87 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $91.20 Typical High $107.15 | Professional | 55 · Aftercare only | $83.18 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $60.26 Typical High $72.44 | Professional | 56 · Pre-op care only | $54.95 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $501.19 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $229.09 Median $316.23 Typical High $380.19 | Professional | 51 · Multiple procedures | $229.09 | $316.23 | $380.19 |
Where Indiana sits
The same service costs 4.6 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 $8,780MT $1,889
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.