How much rates vary
Facilitymedian $8,913 · 10th to 90th $1,738 to $29,512Professionalmedian $1,380 · 10th to 90th $1,047 to $2,089
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 $1,071.52 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,071.52 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,071.52 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,398.83 Median $15,488.17 Typical High $33,884.42 | Facility | None | $2,398.83 | $15,488.17 | $33,884.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,479.11 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $933.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $660.69 | $933.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $234.42 Typical High $323.59 | Professional | 80 · Assistant surgeon | $169.82 | $234.42 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $208.93 Typical High $275.42 | Professional | AS · PA/NP assist | $147.91 | $208.93 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $7,244.36 | Facility | None | $1,230.27 | $1,230.27 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $5,623.41 Typical High $7,943.28 | Facility | None | $1,659.59 | $5,623.41 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $6,606.93 | Professional | None | $1,047.13 | $1,412.54 | $6,606.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $7,585.78 Typical High $10,471.29 | Facility | None | $2,089.30 | $7,585.78 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,659.59 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,248.07 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,248.07 | $14,454.40 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $2,041.74 | Professional | None | $933.25 | $1,258.93 | $2,041.74 |
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 $537.03 Median $537.03 Typical High $645.65 | Professional | 52 · Reduced service | $537.03 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $257.04 | Professional | 53 · Discontinued | $213.80 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $977.24 | Professional | 54 · Surgery only | $794.33 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $162.18 Typical High $194.98 | Professional | 55 · Aftercare only | $158.49 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $128.82 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $912.01 |
Where Indiana sits
The same service costs 5.5 times more in Colorado than in West Virginia. 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 $14,842WV $2,709
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.