How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,096 to $17,783Professionalmedian $1,413 · 10th to 90th $1,000 to $2,188
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 $1,000.00 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,000.00 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,148.15 | Professional | None | $933.25 | $1,000.00 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,230.27 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,412.54 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,137.96 Typical High $2,884.03 | Professional | 50 · Both sides | $1,819.70 | $2,137.96 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $229.09 Typical High $323.59 | Professional | 80 · Assistant surgeon | $194.98 | $229.09 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $199.53 Typical High $269.15 | Professional | AS · PA/NP assist | $169.82 | $199.53 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $10,964.78 Typical High $19,952.62 | Facility | None | $645.65 | $10,964.78 | $19,952.62 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $5,128.61 | Professional | None | $1,071.52 | $1,258.93 | $5,128.61 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $17,782.79 Typical High $23,988.33 | Facility | None | $912.01 | $17,782.79 | $23,988.33 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,230.27 Median $2,570.40 Typical High $3,235.94 | Professional | None | $1,230.27 | $2,570.40 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,445.44 Typical High $2,818.38 | Professional | None | $891.25 | $1,445.44 | $2,818.38 |
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 $467.74 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $467.74 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $223.87 | Professional | 53 · Discontinued | $186.21 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $758.58 Typical High $831.76 | Professional | 54 · Surgery only | $691.83 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $151.36 Typical High $169.82 | Professional | 55 · Aftercare only | $138.04 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $112.20 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $707.95 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $645.65 | $707.95 | $776.25 |
Where Indiana sits
The same service costs 46.8 times more in Alaska than in Hawaii. 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
$1,413
AK $4,467HI $95.50
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.