How much rates vary
Facilitymedian $10,715 · 10th to 90th $1,413 to $39,811Professionalmedian $1,259 · 10th to 90th $891 to $1,862
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 $977.24 Median $5,011.87 Typical High $16,595.87 | Facility | None | $977.24 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,122.02 | Professional | None | $912.01 | $977.24 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $20,892.96 Typical High $45,708.82 | Facility | None | $1,513.56 | $20,892.96 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $1,698.24 | Professional | None | $891.25 | $1,348.96 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $2,041.74 Typical High $2,691.53 | Professional | 50 · Both sides | $1,348.96 | $2,041.74 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $218.78 Typical High $288.40 | Professional | 80 · Assistant surgeon | $144.54 | $218.78 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $190.55 Typical High $251.19 | Professional | AS · PA/NP assist | $125.89 | $190.55 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $20,417.38 | Facility | None | $1,096.48 | $1,096.48 | $20,417.38 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $12,589.25 Typical High $20,892.96 | Facility | None | $891.25 | $12,589.25 | $20,892.96 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $6,456.54 | Professional | None | $1,071.52 | $1,258.93 | $6,456.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $18,620.87 Typical High $25,118.86 | Facility | None | $2,089.30 | $18,620.87 | $25,118.86 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,479.11 | $2,089.30 |
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 $851.14 Median $1,122.02 Typical High $1,862.09 | Professional | None | $851.14 | $1,122.02 | $1,862.09 |
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 $446.68 Median $489.78 Typical High $549.54 | Professional | 52 · Reduced service | $446.68 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $218.78 | Professional | 53 · Discontinued | $181.97 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $109.65 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $691.83 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $691.83 | $758.58 |
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· 31st of 51
$1,349
AK $4,365TX $550
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.