How much rates vary
Facilitymedian $13,804 · 10th to 90th $1,738 to $31,623Professionalmedian $4,898 · 10th to 90th $3,236 to $7,413
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 $3,630.78 Typical High $5,011.87 | Facility | None | $2,344.23 | $3,630.78 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $3,311.31 Median $3,630.78 Typical High $4,073.80 | Professional | None | $3,311.31 | $3,630.78 | $4,073.80 |
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 $3,162.28 Median $5,623.41 Typical High $6,918.31 | Professional | None | $3,162.28 | $5,623.41 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,786.30 Median $8,511.38 Typical High $10,471.29 | Professional | 50 · Both sides | $4,786.30 | $8,511.38 | $10,471.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,995.26 Median $3,548.13 Typical High $4,466.84 | Professional | 62 · Two surgeons | $1,995.26 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $912.01 Typical High $1,230.27 | Professional | 80 · Assistant surgeon | $512.86 | $912.01 | $1,230.27 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $446.68 Median $794.33 Typical High $977.24 | Professional | AS · PA/NP assist | $446.68 | $794.33 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $18,197.01 Typical High $30,199.52 | Facility | None | $645.65 | $18,197.01 | $30,199.52 |
Cigna Setting Professional Modifier None Typical Low $4,073.80 Median $4,897.79 Typical High $28,183.83 | Professional | None | $4,073.80 | $4,897.79 | $28,183.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $9,549.93 Typical High $34,673.69 | Facility | None | $954.99 | $9,549.93 | $34,673.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3,801.89 Median $5,495.41 Typical High $7,762.47 | Professional | None | $3,801.89 | $5,495.41 | $7,762.47 |
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 $3,162.28 Median $4,365.16 Typical High $7,244.36 | Professional | None | $3,162.28 | $4,365.16 | $7,244.36 |
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 $1,659.59 Median $1,819.70 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,659.59 | $1,819.70 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $724.44 Typical High $812.83 | Professional | 53 · Discontinued | $660.69 | $724.44 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,691.53 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,511.89 | $2,691.53 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $537.03 Typical High $602.56 | Professional | 55 · Aftercare only | $501.19 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $363.08 Typical High $407.38 | Professional | 56 · Pre-op care only | $331.13 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,511.89 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,511.89 | $2,818.38 |
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
$5,129
AK $15,849TX $776
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.