How much rates vary
Facilitymedian $3,631 · 10th to 90th $851 to $8,913Professionalmedian $1,023 · 10th to 90th $646 to $2,512
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 $741.31 Median $5,011.87 Typical High $11,220.18 | Facility | None | $741.31 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,000.00 | Professional | None | $741.31 | $741.31 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $2,511.89 Typical High $2,818.38 | Professional | None | $645.65 | $2,511.89 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $3,715.35 Typical High $4,570.88 | Professional | 50 · Both sides | $977.24 | $3,715.35 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $398.11 Typical High $524.81 | Professional | 80 · Assistant surgeon | $104.71 | $398.11 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $346.74 Typical High $398.11 | Professional | AS · PA/NP assist | $91.20 | $346.74 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $2,511.89 | Facility | None | $776.25 | $776.25 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,621.81 Typical High $3,235.94 | Facility | None | $724.44 | $1,621.81 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,445.44 | Professional | None | $602.56 | $870.96 | $1,445.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,949.84 Median $2,691.53 Typical High $3,311.31 | Facility | None | $1,949.84 | $2,691.53 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,445.44 | Professional | None | $794.33 | $1,071.52 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,621.81 | Professional | None | $724.44 | $891.25 | $1,621.81 |
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 $371.54 Median $371.54 Typical High $436.52 | Professional | 52 · Reduced service | $371.54 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $173.78 | Professional | 53 · Discontinued | $147.91 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $549.54 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $87.10 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $616.60 |
Where Indiana sits
The same service costs 3.7 times more in Oklahoma than in Mississippi. 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
OK $7,181MS $1,948
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.