How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,000 to $28,840Professionalmedian $1,148 · 10th to 90th $776 to $1,738
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 $851.14 Median $5,011.87 Typical High $11,220.18 | Facility | None | $851.14 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $954.99 | Professional | None | $776.25 | $851.14 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,230.27 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $776.25 | $1,288.25 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,905.46 Typical High $2,398.83 | Professional | 50 · Both sides | $1,174.90 | $1,905.46 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $204.17 Typical High $275.42 | Professional | 80 · Assistant surgeon | $125.89 | $204.17 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $177.83 Typical High $223.87 | Professional | AS · PA/NP assist | $109.65 | $177.83 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $7,244.36 | Facility | None | $933.25 | $933.25 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,467.37 Typical High $7,762.47 | Facility | None | $645.65 | $3,467.37 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $7,413.10 | Professional | None | $933.25 | $1,258.93 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $5,370.32 Typical High $10,471.29 | Facility | None | $912.01 | $5,370.32 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,862.09 | Professional | None | $933.25 | $1,288.25 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,698.24 | Professional | None | $741.31 | $1,000.00 | $1,698.24 |
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 $389.05 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $588.84 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $85.11 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $660.69 |
Where Indiana sits
The same service costs 14.5 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
$1,288
AK $3,715TX $257
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.