How much rates vary
Facilitymedian $3,890 · 10th to 90th $891 to $8,710Professionalmedian $871 · 10th to 90th $562 to $1,202
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 $645.65 Median $5,011.87 Typical High $11,220.18 | Facility | None | $645.65 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | None | $645.65 | $645.65 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $5,248.07 Typical High $9,549.93 | Facility | None | $933.25 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $933.25 Typical High $1,122.02 | Professional | None | $562.34 | $933.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,380.38 Typical High $1,698.24 | Professional | 50 · Both sides | $851.14 | $1,380.38 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $588.84 Typical High $707.95 | Professional | 62 · Two surgeons | $354.81 | $588.84 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $147.91 Typical High $199.53 | Professional | 80 · Assistant surgeon | $89.13 | $147.91 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $128.82 Typical High $158.49 | Professional | AS · PA/NP assist | $79.43 | $128.82 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $4,365.16 | Facility | None | $676.08 | $676.08 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,630.27 Typical High $4,677.35 | Facility | None | $645.65 | $2,630.27 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $831.76 Typical High $1,380.38 | Professional | None | $524.81 | $831.76 | $1,380.38 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,288.25 Median $3,801.89 Typical High $5,888.44 | Facility | None | $1,288.25 | $3,801.89 | $5,888.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,288.25 | Professional | None | $758.58 | $1,047.13 | $1,288.25 |
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 $645.65 Median $812.83 Typical High $1,412.54 | Professional | None | $645.65 | $812.83 | $1,412.54 |
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 $323.59 Median $323.59 Typical High $380.19 | Professional | 52 · Reduced service | $323.59 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | 54 · Surgery only | $478.63 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $537.03 |
Where Indiana sits
The same service costs 3.5 times more in Alaska 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
AK $7,432MT $2,095
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.