How much rates vary
Facilitymedian $6,166 · 10th to 90th $955 to $15,136Professionalmedian $832 · 10th to 90th $617 to $1,259
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 $676.08 Median $5,011.87 Typical High $11,220.18 | Facility | None | $676.08 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $758.58 | Professional | None | $616.60 | $676.08 | $758.58 |
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 $616.60 Median $891.25 Typical High $1,148.15 | Professional | None | $616.60 | $891.25 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,348.96 Typical High $1,778.28 | Professional | 50 · Both sides | $933.25 | $1,348.96 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $144.54 Typical High $194.98 | Professional | 80 · Assistant surgeon | $100.00 | $144.54 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $125.89 Typical High $165.96 | Professional | AS · PA/NP assist | $87.10 | $125.89 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $7,244.36 | Facility | None | $741.31 | $741.31 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,168.69 Typical High $7,762.47 | Facility | None | $645.65 | $4,168.69 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $4,466.84 | Professional | None | $707.95 | $831.76 | $4,466.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,862.09 Median $6,606.93 Typical High $10,471.29 | Facility | None | $1,862.09 | $6,606.93 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,412.54 | Professional | None | $741.31 | $1,023.29 | $1,412.54 |
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 $575.44 Median $758.58 Typical High $1,258.93 | Professional | None | $575.44 | $758.58 | $1,258.93 |
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 $309.03 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $309.03 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $147.91 | Professional | 53 · Discontinued | $123.03 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $549.54 | Professional | 54 · Surgery only | $457.09 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $74.13 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $467.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $426.58 | $467.74 | $512.86 |
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
$891
AK $2,951TX $380
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.