How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,175 to $14,125Professionalmedian $1,862 · 10th to 90th $1,413 to $2,818
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 $5,011.87 Typical High $14,125.38 | Facility | None | $1,380.38 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,479.11 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,288.25 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,412.54 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,258.93 Typical High $1,778.28 | Professional | 62 · Two surgeons | $912.01 | $1,258.93 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $316.23 Typical High $478.63 | Professional | 80 · Assistant surgeon | $234.42 | $316.23 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $275.42 Typical High $398.11 | Professional | AS · PA/NP assist | $204.17 | $275.42 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $4,073.80 | Facility | None | $1,819.70 | $1,819.70 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,818.38 Typical High $4,168.69 | Facility | None | $776.25 | $2,818.38 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,230.27 | $1,862.09 | $3,162.28 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,023.29 Median $4,365.16 Typical High $5,248.07 | Facility | None | $1,023.29 | $4,365.16 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $3,090.30 | Professional | None | $1,659.59 | $2,238.72 | $3,090.30 |
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 $1,380.38 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,737.80 | $2,818.38 |
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 $741.31 Median $741.31 Typical High $891.25 | Professional | 52 · Reduced service | $741.31 | $741.31 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $363.08 | Professional | 53 · Discontinued | $295.12 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $269.15 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $181.97 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,258.93 |
Where Indiana sits
The same service costs 8.7 times more in Alaska than in Texas. 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.
Indiana· 30th of 51
$1,995
AK $7,244TX $832
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.