How much rates vary
Facilitymedian $5,754 · 10th to 90th $933 to $14,125Professionalmedian $676 · 10th to 90th $501 to $1,000
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 $524.81 Median $5,011.87 Typical High $11,220.18 | Facility | None | $524.81 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $602.56 | Professional | None | $478.63 | $524.81 | $602.56 |
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 $501.19 Median $676.08 Typical High $891.25 | Professional | None | $501.19 | $676.08 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,000.00 Typical High $1,348.96 | Professional | 50 · Both sides | $741.31 | $1,000.00 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $426.58 Typical High $562.34 | Professional | 62 · Two surgeons | $316.23 | $426.58 | $562.34 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $107.15 Typical High $147.91 | Professional | 80 · Assistant surgeon | $79.43 | $107.15 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $93.33 Typical High $125.89 | Professional | AS · PA/NP assist | $69.18 | $93.33 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $7,244.36 | Facility | None | $575.44 | $575.44 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,786.30 Typical High $7,943.28 | Facility | None | $630.96 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $3,801.89 | Professional | None | $562.34 | $707.95 | $3,801.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $5,248.07 Typical High $10,471.29 | Facility | None | $912.01 | $5,248.07 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $1,122.02 | Professional | None | $537.03 | $794.33 | $1,122.02 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $977.24 | Professional | None | $446.68 | $602.56 | $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 $239.88 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $239.88 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $95.50 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $426.58 | Professional | 54 · Surgery only | $363.08 | $398.11 | $426.58 |
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 $47.86 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $371.54 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $398.11 |
Where Indiana sits
The same service costs 7.6 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· 34th of 51
$676
AK $2,344TX $309
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.