How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,230 to $19,498Professionalmedian $1,072 · 10th to 90th $724 to $1,479
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 $831.76 Median $3,467.37 Typical High $14,125.38 | Facility | None | $831.76 | $3,467.37 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,122.02 | Professional | None | $831.76 | $831.76 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $11,220.18 Typical High $22,908.68 | Facility | None | $1,412.54 | $11,220.18 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,348.96 Typical High $1,412.54 | Professional | None | $724.44 | $1,348.96 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,995.26 Typical High $2,137.96 | Professional | 50 · Both sides | $1,071.52 | $1,995.26 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $851.14 Typical High $912.01 | Professional | 62 · Two surgeons | $457.09 | $851.14 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $213.80 Typical High $234.42 | Professional | 80 · Assistant surgeon | $114.82 | $213.80 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $186.21 Typical High $199.53 | Professional | AS · PA/NP assist | $100.00 | $186.21 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $4,365.16 | Facility | None | $891.25 | $891.25 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,162.28 Typical High $4,786.30 | Facility | None | $776.25 | $3,162.28 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,621.81 | Professional | None | $676.08 | $933.25 | $1,621.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $3,890.45 Typical High $5,888.44 | Facility | None | $2,089.30 | $3,890.45 | $5,888.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,621.81 | Professional | None | $977.24 | $1,318.26 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,778.28 | Professional | None | $812.83 | $977.24 | $1,778.28 |
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 $416.87 Median $416.87 Typical High $489.78 | Professional | 52 · Reduced service | $416.87 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | 53 · Discontinued | $165.96 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $741.31 | Professional | 54 · Surgery only | $630.96 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $691.83 |
Where Indiana sits
The same service costs 3.7 times more in Wisconsin 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
WI $9,756MT $2,637
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.