How much rates vary
Facilitymedian $3,981 · 10th to 90th $977 to $14,125Professionalmedian $537 · 10th to 90th $427 to $912
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 $537.03 Median $5,011.87 Typical High $11,220.18 | Facility | None | $537.03 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $602.56 | Professional | None | $489.78 | $537.03 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,047.13 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $660.69 | Professional | None | $398.11 | $467.74 | $660.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $691.83 Typical High $1,023.29 | Professional | 50 · Both sides | $588.84 | $691.83 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $63.10 Median $74.13 Typical High $114.82 | Professional | 80 · Assistant surgeon | $63.10 | $74.13 | $114.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $64.57 Typical High $95.50 | Professional | AS · PA/NP assist | $54.95 | $64.57 | $95.50 |
CareSource Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $3,235.94 | Facility | None | $588.84 | $588.84 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,344.23 Typical High $3,548.13 | Facility | None | $630.96 | $2,344.23 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $3,981.07 | Professional | None | $575.44 | $724.44 | $3,981.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,258.93 Median $3,388.44 Typical High $5,248.07 | Facility | None | $1,258.93 | $3,388.44 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $1,148.15 | Professional | None | $562.34 | $831.76 | $1,148.15 |
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 $457.09 Median $588.84 Typical High $977.24 | Professional | None | $457.09 | $588.84 | $977.24 |
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 $245.47 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $245.47 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $97.72 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $363.08 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $407.38 |
Where Indiana sits
The same service costs 8.9 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· 43rd of 51
$589
AK $2,344TX $263
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.