How much rates vary
Facilitymedian $2,239 · 10th to 90th $525 to $5,248Professionalmedian $501 · 10th to 90th $398 to $891
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 $501.19 Median $5,011.87 Typical High $11,220.18 | Facility | None | $501.19 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $575.44 | Professional | None | $467.74 | $501.19 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $3,235.94 Typical High $6,309.57 | Facility | None | $891.25 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $630.96 | Professional | None | $371.54 | $446.68 | $630.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $275.42 Typical High $407.38 | Professional | 62 · Two surgeons | $234.42 | $275.42 | $407.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $70.79 Typical High $109.65 | Professional | 80 · Assistant surgeon | $60.26 | $70.79 | $109.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $61.66 Typical High $91.20 | Professional | AS · PA/NP assist | $52.48 | $61.66 | $91.20 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $776.25 | Facility | None | $562.34 | $562.34 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $660.69 Typical High $1,479.11 | Facility | None | $446.68 | $660.69 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $3,467.37 | Professional | None | $537.03 | $660.69 | $3,467.37 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $588.84 Median $933.25 Typical High $2,089.30 | Facility | None | $588.84 | $933.25 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $1,071.52 | Professional | None | $512.86 | $776.25 | $1,071.52 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $954.99 | Professional | None | $436.52 | $562.34 | $954.99 |
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 $234.42 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $234.42 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $100.00 Typical High $112.20 | Professional | 53 · Discontinued | $93.33 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $416.87 | Professional | 54 · Surgery only | $346.74 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $56.23 | Professional | 56 · Pre-op care only | $46.77 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $389.05 |
Where Indiana sits
The same service costs 6.3 times more in Alaska than in Utah. 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· 43rd of 51
$550
AK $2,239UT $355
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.