How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,023 to $28,840Professionalmedian $741 · 10th to 90th $550 to $1,072
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 $588.84 Median $5,011.87 Typical High $14,125.38 | Facility | None | $588.84 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $660.69 | Professional | None | $537.03 | $588.84 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,479.11 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $977.24 | Professional | None | $549.54 | $758.58 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,148.15 Typical High $1,513.56 | Professional | 50 · Both sides | $812.83 | $1,148.15 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $123.03 Typical High $165.96 | Professional | 80 · Assistant surgeon | $87.10 | $123.03 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $107.15 Typical High $141.25 | Professional | AS · PA/NP assist | $75.86 | $107.15 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $7,244.36 | Facility | None | $645.65 | $645.65 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,168.69 Typical High $7,762.47 | Facility | None | $707.95 | $4,168.69 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $4,073.80 | Professional | None | $616.60 | $758.58 | $4,073.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,659.59 Median $7,585.78 Typical High $10,471.29 | Facility | None | $1,659.59 | $7,585.78 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,258.93 | Professional | None | $630.96 | $912.01 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,096.48 | Professional | None | $501.19 | $660.69 | $1,096.48 |
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 $269.15 Median $295.12 Typical High $323.59 | Professional | 52 · Reduced service | $269.15 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $128.82 | Professional | 53 · Discontinued | $107.15 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $398.11 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $97.72 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $64.57 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $371.54 | $407.38 | $446.68 |
Where Indiana sits
The same service costs 8.3 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· 34th of 51
$759
AK $2,570TX $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.