How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,175 to $19,498Professionalmedian $851 · 10th to 90th $646 to $1,288
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 $707.95 Median $5,011.87 Typical High $16,595.87 | Facility | None | $707.95 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $794.33 | Professional | None | $645.65 | $707.95 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $11,481.54 Typical High $23,988.33 | Facility | None | $1,479.11 | $11,481.54 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,148.15 | Professional | None | $645.65 | $851.14 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,288.25 Typical High $1,737.80 | Professional | 50 · Both sides | $977.24 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $138.04 Typical High $190.55 | Professional | 80 · Assistant surgeon | $104.71 | $138.04 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $120.23 Typical High $158.49 | Professional | AS · PA/NP assist | $91.20 | $120.23 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $1,318.26 Typical High $1,995.26 | Facility | None | $776.25 | $1,318.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,467.37 Typical High $6,456.54 | Facility | None | $691.83 | $3,467.37 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $4,365.16 | Professional | None | $741.31 | $870.96 | $4,365.16 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,235.94 Typical High $8,511.38 | Facility | None | $954.99 | $3,235.94 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,548.82 | Professional | None | $741.31 | $1,071.52 | $1,548.82 |
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 $630.96 Median $812.83 Typical High $1,348.96 | Professional | None | $630.96 | $812.83 | $1,348.96 |
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 $323.59 Median $354.81 Typical High $389.05 | Professional | 52 · Reduced service | $323.59 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $128.82 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $478.63 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $117.49 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $70.79 Typical High $77.62 | Professional | 56 · Pre-op care only | $64.57 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $446.68 | $501.19 | $537.03 |
Where Indiana sits
The same service costs 16.6 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· 38th of 51
$851
AK $3,090TX $186
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.