How much rates vary
Facilitymedian $13,490 · 10th to 90th $1,738 to $31,623Professionalmedian $3,162 · 10th to 90th $2,239 to $4,786
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 $2,344.23 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,344.23 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,511.89 Typical High $2,818.38 | Professional | None | $2,344.23 | $2,511.89 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,398.83 Median $15,488.17 Typical High $33,884.42 | Facility | None | $2,398.83 | $15,488.17 | $33,884.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Professional | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,388.44 Median $5,370.32 Typical High $6,760.83 | Professional | 50 · Both sides | $3,388.44 | $5,370.32 | $6,760.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $2,238.72 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,412.54 | $2,238.72 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $575.44 Typical High $776.25 | Professional | 80 · Assistant surgeon | $363.08 | $575.44 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $501.19 Typical High $630.96 | Professional | AS · PA/NP assist | $316.23 | $501.19 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $2,818.38 | Facility | None | $1,548.82 | $2,344.23 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $16,218.10 Typical High $29,512.09 | Facility | None | $676.08 | $16,218.10 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $17,378.01 | Professional | None | $2,630.27 | $3,235.94 | $17,378.01 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $6,760.83 Typical High $34,673.69 | Facility | None | $954.99 | $6,760.83 | $34,673.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,691.53 Median $3,801.89 Typical High $5,370.32 | Professional | None | $2,691.53 | $3,801.89 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $8,912.51 Typical High $16,218.10 | Facility | None | $1,621.81 | $8,912.51 | $16,218.10 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $4,786.30 | Professional | None | $2,187.76 | $2,691.53 | $4,786.30 |
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 $1,174.90 Median $1,258.93 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,174.90 | $1,258.93 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $501.19 Typical High $562.34 | Professional | 53 · Discontinued | $467.74 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,905.46 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,737.80 | $1,905.46 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $380.19 Typical High $426.58 | Professional | 55 · Aftercare only | $346.74 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $251.19 Typical High $281.84 | Professional | 56 · Pre-op care only | $234.42 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,778.28 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,778.28 | $1,949.84 |
Where Indiana sits
The same service costs 20.0 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· 26th of 51
$3,467
AK $11,220TX $562
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.