How much rates vary
Facilitymedian $10,965 · 10th to 90th $1,479 to $27,542Professionalmedian $2,455 · 10th to 90th $1,660 to $3,467
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 $1,659.59 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,659.59 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,659.59 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $19,952.62 Typical High $28,183.83 | Facility | None | $2,570.40 | $19,952.62 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $2,454.71 Typical High $3,235.94 | Professional | None | $1,621.81 | $2,454.71 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $3,715.35 Typical High $5,011.87 | Professional | 50 · Both sides | $2,454.71 | $3,715.35 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,548.82 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,023.29 | $1,548.82 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $398.11 Typical High $562.34 | Professional | 80 · Assistant surgeon | $257.04 | $398.11 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $346.74 Typical High $467.74 | Professional | AS · PA/NP assist | $229.09 | $346.74 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $3,981.07 | Professional | None | $2,089.30 | $2,511.89 | $3,981.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $5,128.61 | Facility | None | $912.01 | $2,454.71 | $5,128.61 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,570.40 | $3,548.13 |
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 $1,862.09 Median $2,290.87 Typical High $3,548.13 | Professional | None | $1,862.09 | $2,290.87 | $3,548.13 |
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 $831.76 Median $831.76 Typical High $954.99 | Professional | 52 · Reduced service | $831.76 | $831.76 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $389.05 | Professional | 53 · Discontinued | $331.13 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,348.96 |
Where Indiana sits
The same service costs 8.5 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· 31st of 51
$2,455
AK $8,128TX $955
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.