How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,479 to $28,840Professionalmedian $1,349 · 10th to 90th $955 to $1,995
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 $1,122.02 Median $1,318.26 Typical High $11,220.18 | Facility | None | $1,122.02 | $1,318.26 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,258.93 | Professional | None | $977.24 | $1,000.00 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $14,791.08 Typical High $33,113.11 | Facility | None | $2,691.53 | $14,791.08 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $1,862.09 | Professional | None | $954.99 | $1,479.11 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $2,238.72 Typical High $2,884.03 | Professional | 50 · Both sides | $1,412.54 | $2,238.72 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $933.25 Typical High $1,202.26 | Professional | 62 · Two surgeons | $602.56 | $933.25 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $239.88 Typical High $323.59 | Professional | 80 · Assistant surgeon | $151.36 | $239.88 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $208.93 Typical High $269.15 | Professional | AS · PA/NP assist | $131.83 | $208.93 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $7,244.36 | Facility | None | $1,122.02 | $1,122.02 | $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 $1,348.96 Typical High $6,606.93 | Professional | None | $1,047.13 | $1,348.96 | $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 $1,148.15 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,513.56 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $6,309.57 Typical High $14,454.40 | Facility | None | $1,230.27 | $6,309.57 | $14,454.40 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,995.26 | Professional | None | $912.01 | $1,230.27 | $1,995.26 |
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 $489.78 Median $501.19 Typical High $575.44 | Professional | 52 · Reduced service | $489.78 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $234.42 | Professional | 53 · Discontinued | $194.98 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $741.31 Typical High $870.96 | Professional | 54 · Surgery only | $724.44 | $741.31 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $173.78 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $691.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $676.08 | $691.83 | $812.83 |
Where Indiana sits
The same service costs 5.0 times more in Colorado than in Kentucky. 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 $14,731KY $2,968
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.