How much rates vary
Facilitymedian $13,490 · 10th to 90th $1,738 to $31,623Professionalmedian $3,890 · 10th to 90th $2,630 to $6,026
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 $2,754.23 Median $3,019.95 Typical High $3,311.31 | Professional | None | $2,754.23 | $3,019.95 | $3,311.31 |
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 $2,630.27 Median $4,570.88 Typical High $5,623.41 | Professional | None | $2,630.27 | $4,570.88 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,981.07 Median $6,918.31 Typical High $8,511.38 | Professional | 50 · Both sides | $3,981.07 | $6,918.31 | $8,511.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $2,884.03 Typical High $3,630.78 | Professional | 62 · Two surgeons | $1,659.59 | $2,884.03 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $741.31 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $426.58 | $741.31 | $1,000.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $645.65 Typical High $794.33 | Professional | AS · PA/NP assist | $371.54 | $645.65 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
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 $3,311.31 Median $3,981.07 Typical High $20,892.96 | Professional | None | $3,311.31 | $3,981.07 | $20,892.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $8,128.31 Typical High $34,673.69 | Facility | None | $954.99 | $8,128.31 | $34,673.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3,162.28 Median $4,570.88 Typical High $6,456.54 | Professional | None | $3,162.28 | $4,570.88 | $6,456.54 |
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 $2,630.27 Median $3,388.44 Typical High $5,754.40 | Professional | None | $2,630.27 | $3,388.44 | $5,754.40 |
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 $1,380.38 Median $1,513.56 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,380.38 | $1,513.56 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $602.56 Typical High $676.08 | Professional | 53 · Discontinued | $549.54 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,238.72 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,089.30 | $2,238.72 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $446.68 Typical High $501.19 | Professional | 55 · Aftercare only | $416.87 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $302.00 Typical High $331.13 | Professional | 56 · Pre-op care only | $275.42 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,089.30 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,089.30 | $2,344.23 |
Where Indiana sits
The same service costs 20.4 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
$4,169
AK $13,183TX $646
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.