How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,514 to $19,498Professionalmedian $1,622 · 10th to 90th $1,349 to $2,692
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 $1,479.11 Median $5,011.87 Typical High $17,782.79 | Facility | None | $1,479.11 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,479.11 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $11,220.18 Typical High $22,908.68 | Facility | None | $1,737.80 | $11,220.18 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,348.96 | $1,621.81 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,454.71 Typical High $3,311.31 | Professional | 50 · Both sides | $2,041.74 | $2,454.71 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,023.29 Typical High $1,380.38 | Professional | 62 · Two surgeons | $851.14 | $1,023.29 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $263.03 Typical High $371.54 | Professional | 80 · Assistant surgeon | $218.78 | $263.03 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $229.09 Typical High $309.03 | Professional | AS · PA/NP assist | $190.55 | $229.09 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $10,232.93 | Facility | None | $1,621.81 | $1,621.81 | $10,232.93 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $6,606.93 Typical High $10,964.78 | Facility | None | $1,230.27 | $6,606.93 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $7,943.28 | Professional | None | $1,412.54 | $1,862.09 | $7,943.28 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $8,511.38 Typical High $12,589.25 | Facility | None | $2,089.30 | $8,511.38 | $12,589.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,548.82 Median $2,238.72 Typical High $3,235.94 | Professional | None | $1,548.82 | $2,238.72 | $3,235.94 |
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 $1,318.26 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,659.59 | $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 $676.08 Median $741.31 Typical High $812.83 | Professional | 52 · Reduced service | $676.08 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $295.12 Typical High $323.59 | Professional | 53 · Discontinued | $269.15 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,122.02 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,122.02 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $223.87 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $147.91 Typical High $162.18 | Professional | 56 · Pre-op care only | $134.90 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,122.02 |
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· 40th of 51
$1,622
AK $6,457TX $324
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.