How much rates vary
Facilitymedian $8,710 · 10th to 90th $1,514 to $28,840Professionalmedian $1,549 · 10th to 90th $1,096 to $2,399
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 $1,380.38 Median $1,513.56 Typical High $16,595.87 | Facility | None | $1,380.38 | $1,513.56 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,174.90 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,023.29 | $1,659.59 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 80 · Assistant surgeon | $162.18 | $162.18 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $15,488.17 Typical High $33,113.11 | Facility | None | $2,754.23 | $15,488.17 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,737.80 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,570.40 Typical High $3,388.44 | Professional | 50 · Both sides | $1,659.59 | $2,570.40 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $1,096.48 Typical High $1,445.44 | Professional | 62 · Two surgeons | $691.83 | $1,096.48 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $275.42 Typical High $371.54 | Professional | 80 · Assistant surgeon | $173.78 | $275.42 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $239.88 Typical High $316.23 | Professional | AS · PA/NP assist | $154.88 | $239.88 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $7,244.36 | Facility | None | $1,318.26 | $1,318.26 | $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 $1,174.90 Median $1,548.82 Typical High $7,585.78 | Professional | None | $1,174.90 | $1,548.82 | $7,585.78 |
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 $1,318.26 Median $1,778.28 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,778.28 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $6,918.31 Typical High $14,454.40 | Facility | None | $1,230.27 | $6,918.31 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,380.38 | $2,238.72 |
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 $575.44 Median $588.84 Typical High $676.08 | Professional | 52 · Reduced service | $575.44 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $234.42 Typical High $275.42 | Professional | 53 · Discontinued | $229.09 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $891.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $851.14 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $177.83 Typical High $204.17 | Professional | 55 · Aftercare only | $169.82 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $117.49 Typical High $134.90 | Professional | 56 · Pre-op care only | $114.82 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $831.76 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $794.33 | $831.76 | $954.99 |
Where Indiana sits
The same service costs 4.7 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 $15,002KY $3,224
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.