How much rates vary
Facilitymedian $4,074 · 10th to 90th $891 to $14,125Professionalmedian $692 · 10th to 90th $550 to $1,023
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 $575.44 Median $5,011.87 Typical High $11,220.18 | Facility | None | $575.44 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $660.69 | Professional | None | $537.03 | $575.44 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,071.52 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $933.25 | Professional | None | $549.54 | $707.95 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,071.52 Typical High $1,412.54 | Professional | 50 · Both sides | $812.83 | $1,071.52 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $446.68 Typical High $602.56 | Professional | 62 · Two surgeons | $346.74 | $446.68 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $112.20 Typical High $158.49 | Professional | 80 · Assistant surgeon | $87.10 | $112.20 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $100.00 Typical High $131.83 | Professional | AS · PA/NP assist | $75.86 | $100.00 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $3,235.94 | Facility | None | $645.65 | $645.65 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,905.46 Typical High $3,467.37 | Facility | None | $630.96 | $1,905.46 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $3,548.13 | Professional | None | $616.60 | $707.95 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,584.89 Median $3,388.44 Typical High $5,248.07 | Facility | None | $1,584.89 | $3,388.44 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,230.27 | Professional | None | $588.84 | $891.25 | $1,230.27 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $1,096.48 | Professional | None | $501.19 | $645.65 | $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 $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $269.15 | $288.40 | $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 $79.43 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $64.57 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $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 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· 36th of 51
$708
AK $2,570TX $331
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.