How much rates vary
Facilitymedian $8,913 · 10th to 90th $1,413 to $28,840Professionalmedian $1,047 · 10th to 90th $776 to $1,622
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 $831.76 Median $5,011.87 Typical High $16,595.87 | Facility | None | $831.76 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $954.99 | Professional | None | $776.25 | $831.76 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,778.28 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,513.56 | Professional | None | $776.25 | $1,202.26 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,778.28 Typical High $2,290.87 | Professional | 50 · Both sides | $1,148.15 | $1,778.28 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $758.58 Typical High $977.24 | Professional | 62 · Two surgeons | $478.63 | $758.58 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $190.55 Typical High $257.04 | Professional | 80 · Assistant surgeon | $123.03 | $190.55 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $165.96 Typical High $213.80 | Professional | AS · PA/NP assist | $107.15 | $165.96 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $10,471.29 | Facility | None | $933.25 | $933.25 | $10,471.29 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $5,888.44 Typical High $10,964.78 | Facility | None | $891.25 | $5,888.44 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $5,495.41 | Professional | None | $891.25 | $1,047.13 | $5,495.41 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,905.46 Median $10,232.93 Typical High $13,182.57 | Facility | None | $1,905.46 | $10,232.93 | $13,182.57 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,778.28 | Professional | None | $912.01 | $1,288.25 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,584.89 | Professional | None | $724.44 | $977.24 | $1,584.89 |
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 $389.05 Median $416.87 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $691.83 | Professional | 54 · Surgery only | $575.44 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $645.65 |
Where Indiana sits
The same service costs 7.9 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· 28th of 51
$1,202
AK $3,715TX $468
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.