How much rates vary
Facilitymedian $3,631 · 10th to 90th $617 to $14,125Professionalmedian $479 · 10th to 90th $372 to $708
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 $398.11 Median $5,011.87 Typical High $5,623.41 | Facility | None | $398.11 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $446.68 | Professional | None | $363.08 | $398.11 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $7,413.10 Typical High $17,378.01 | Facility | None | $724.44 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $660.69 | Professional | None | $380.19 | $501.19 | $660.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $741.31 Typical High $1,000.00 | Professional | 50 · Both sides | $562.34 | $741.31 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $239.88 Median $316.23 Typical High $426.58 | Professional | 62 · Two surgeons | $239.88 | $316.23 | $426.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $79.43 Typical High $109.65 | Professional | 80 · Assistant surgeon | $60.26 | $79.43 | $109.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $69.18 Typical High $93.33 | Professional | AS · PA/NP assist | $52.48 | $69.18 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $3,235.94 | Facility | None | $436.52 | $436.52 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $1,659.59 Typical High $3,467.37 | Facility | None | $416.87 | $1,659.59 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $2,570.40 | Professional | None | $407.38 | $478.63 | $2,570.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,148.15 Median $3,235.94 Typical High $4,677.35 | Facility | None | $1,148.15 | $3,235.94 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $851.14 | Professional | None | $389.05 | $616.60 | $851.14 |
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 $338.84 Median $426.58 Typical High $741.31 | Professional | None | $338.84 | $426.58 | $741.31 |
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 $181.97 Median $194.98 Typical High $213.80 | Professional | 52 · Reduced service | $181.97 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $79.43 Typical High $87.10 | Professional | 53 · Discontinued | $72.44 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $295.12 Typical High $323.59 | Professional | 54 · Surgery only | $269.15 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $58.88 Typical High $64.57 | Professional | 55 · Aftercare only | $53.70 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $39.81 Typical High $42.66 | Professional | 56 · Pre-op care only | $36.31 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $275.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $251.19 | $275.42 | $302.00 |
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· 33rd of 51
$501
AK $1,738TX $209
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.