How much rates vary
Facilitymedian $4,266 · 10th to 90th $933 to $14,125Professionalmedian $1,096 · 10th to 90th $741 to $1,585
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 $851.14 Median $5,011.87 Typical High $11,220.18 | Facility | None | $851.14 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,023.29 | Professional | None | $851.14 | $851.14 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,047.13 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,202.26 Typical High $1,479.11 | Professional | None | $741.31 | $1,202.26 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,819.70 Typical High $2,187.76 | Professional | 50 · Both sides | $1,096.48 | $1,819.70 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $758.58 Typical High $933.25 | Professional | 62 · Two surgeons | $467.74 | $758.58 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $194.98 Typical High $257.04 | Professional | 80 · Assistant surgeon | $117.49 | $194.98 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $169.82 Typical High $204.17 | Professional | AS · PA/NP assist | $102.33 | $169.82 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $3,311.31 | Facility | None | $912.01 | $912.01 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,511.89 Typical High $3,715.35 | Facility | None | $630.96 | $2,511.89 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,698.24 | Professional | None | $676.08 | $954.99 | $1,698.24 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,412.54 Median $2,951.21 Typical High $5,495.41 | Facility | None | $1,412.54 | $2,951.21 | $5,495.41 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,348.96 | $1,659.59 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,778.28 | Professional | None | $812.83 | $1,000.00 | $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 $426.58 Median $426.58 Typical High $512.86 | Professional | 52 · Reduced service | $426.58 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $204.17 | Professional | 53 · Discontinued | $173.78 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $758.58 | Professional | 54 · Surgery only | $645.65 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $707.95 |
Where Indiana sits
The same service costs 3.1 times more in Wisconsin than in Florida. 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 $8,254FL $2,626
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.