How much rates vary
Facilitymedian $5,623 · 10th to 90th $955 to $19,055Professionalmedian $912 · 10th to 90th $646 to $1,318
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 $724.44 Median $1,023.29 Typical High $13,489.63 | Facility | None | $724.44 | $1,023.29 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $1,023.29 | Professional | None | $660.69 | $724.44 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $562.34 Typical High $870.96 | Professional | None | $281.84 | $562.34 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $11,220.18 Typical High $22,908.68 | Facility | None | $1,659.59 | $11,220.18 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $977.24 Typical High $1,288.25 | Professional | None | $616.60 | $977.24 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $616.60 Typical High $831.76 | Professional | 62 · Two surgeons | $389.05 | $616.60 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $158.49 Typical High $218.78 | Professional | 80 · Assistant surgeon | $97.72 | $158.49 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $138.04 Typical High $181.97 | Professional | AS · PA/NP assist | $87.10 | $138.04 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $6,025.60 | Facility | None | $758.58 | $758.58 | $6,025.60 |
CareSource Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $977.24 | Professional | None | $676.08 | $776.25 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $6,456.54 | Facility | None | $776.25 | $3,801.89 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,584.89 | Professional | None | $741.31 | $933.25 | $1,584.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,862.09 Median $6,165.95 Typical High $7,585.78 | Facility | None | $1,862.09 | $6,165.95 | $7,585.78 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,348.96 | Professional | None | $741.31 | $912.01 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,677.35 | $12,022.64 |
United Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,348.96 | Professional | None | $691.83 | $851.14 | $1,348.96 |
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 $331.13 Median $363.08 Typical High $436.52 | Professional | 52 · Reduced service | $331.13 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $147.91 Typical High $173.78 | Professional | 53 · Discontinued | $131.83 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $501.19 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $131.83 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $87.10 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $512.86 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $467.74 | $512.86 | $616.60 |
Where Indiana sits
The same service costs 4.5 times more in Alaska 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
AK $10,099MT $2,245
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.