How much rates vary
Facilitymedian $6,457 · 10th to 90th $933 to $28,840Professionalmedian $977 · 10th to 90th $661 to $1,479
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 $724.44 Median $5,011.87 Typical High $11,220.18 | Facility | None | $724.44 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $812.83 | Professional | None | $660.69 | $724.44 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,122.02 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $1,071.52 Typical High $1,380.38 | Professional | None | $660.69 | $1,071.52 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,621.81 Typical High $2,041.74 | Professional | 50 · Both sides | $1,000.00 | $1,621.81 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $169.82 Typical High $229.09 | Professional | 80 · Assistant surgeon | $104.71 | $169.82 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $151.36 Typical High $190.55 | Professional | AS · PA/NP assist | $93.33 | $151.36 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $7,244.36 | Facility | None | $794.33 | $794.33 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,168.69 Typical High $7,762.47 | Facility | None | $645.65 | $4,168.69 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $6,760.83 | Professional | None | $794.33 | $1,071.52 | $6,760.83 |
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 $794.33 Median $1,071.52 Typical High $1,584.89 | Professional | None | $794.33 | $1,071.52 | $1,584.89 |
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 $616.60 Median $851.14 Typical High $1,479.11 | Professional | None | $616.60 | $851.14 | $1,479.11 |
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 $331.13 Median $354.81 Typical High $398.11 | Professional | 52 · Reduced service | $331.13 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $131.83 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $588.84 | Professional | 54 · Surgery only | $489.78 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $117.49 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $549.54 |
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· 28th of 51
$1,072
AK $3,162TX $417
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.