How much rates vary
Facilitymedian $8,710 · 10th to 90th $1,072 to $28,840Professionalmedian $676 · 10th to 90th $501 to $1,000
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 $537.03 Median $5,011.87 Typical High $11,220.18 | Facility | None | $537.03 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | None | $489.78 | $537.03 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,230.27 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $912.01 | Professional | None | $501.19 | $707.95 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,047.13 Typical High $1,380.38 | Professional | 50 · Both sides | $758.58 | $1,047.13 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $112.20 Typical High $154.88 | Professional | 80 · Assistant surgeon | $81.28 | $112.20 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $97.72 Typical High $128.82 | Professional | AS · PA/NP assist | $70.79 | $97.72 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $7,244.36 | Facility | None | $588.84 | $588.84 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $6,025.60 Typical High $10,232.93 | Facility | None | $630.96 | $6,025.60 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $3,630.78 | Professional | None | $575.44 | $691.83 | $3,630.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,513.56 Median $6,606.93 Typical High $11,748.98 | Facility | None | $1,513.56 | $6,606.93 | $11,748.98 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,148.15 | Professional | None | $575.44 | $831.76 | $1,148.15 |
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 $457.09 Median $602.56 Typical High $1,000.00 | Professional | None | $457.09 | $602.56 | $1,000.00 |
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 $245.47 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $245.47 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $97.72 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $407.38 Typical High $446.68 | Professional | 54 · Surgery only | $371.54 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $74.13 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $380.19 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $346.74 | $380.19 | $416.87 |
Where Indiana sits
The same service costs 7.8 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· 32nd of 51
$708
AK $2,399TX $309
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.