How much rates vary
Facilitymedian $8,913 · 10th to 90th $1,445 to $28,840Professionalmedian $1,148 · 10th to 90th $794 to $1,738
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 $870.96 Median $5,011.87 Typical High $16,595.87 | Facility | None | $870.96 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,000.00 | Professional | None | $812.83 | $870.96 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,778.28 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,288.25 Typical High $1,584.89 | Professional | None | $794.33 | $1,288.25 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,949.84 Typical High $2,398.83 | Professional | 50 · Both sides | $1,202.26 | $1,949.84 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $812.83 Typical High $1,000.00 | Professional | 62 · Two surgeons | $501.19 | $812.83 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $204.17 Typical High $275.42 | Professional | 80 · Assistant surgeon | $128.82 | $204.17 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $181.97 Typical High $223.87 | Professional | AS · PA/NP assist | $112.20 | $181.97 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $7,244.36 | Facility | None | $977.24 | $977.24 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $6,025.60 Typical High $10,232.93 | Facility | None | $891.25 | $6,025.60 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $6,456.54 | Professional | None | $954.99 | $1,174.90 | $6,456.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $6,606.93 Typical High $11,748.98 | Facility | None | $2,089.30 | $6,606.93 | $11,748.98 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,862.09 | Professional | None | $954.99 | $1,318.26 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,659.59 | Professional | None | $758.58 | $1,023.29 | $1,659.59 |
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 $407.38 Median $436.52 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $131.83 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $87.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $676.08 |
Where Indiana sits
The same service costs 7.9 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· 27th of 51
$1,288
AK $3,890TX $490
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.