How much rates vary
Facilitymedian $4,365 · 10th to 90th $933 to $14,125Professionalmedian $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 $707.95 Median $5,011.87 Typical High $11,220.18 | Facility | None | $707.95 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $812.83 | Professional | None | $660.69 | $707.95 | $812.83 |
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 $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 $977.24 Median $1,621.81 Typical High $2,041.74 | Professional | 50 · Both sides | $977.24 | $1,621.81 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $173.78 Typical High $234.42 | Professional | 80 · Assistant surgeon | $104.71 | $173.78 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $151.36 Typical High $190.55 | Professional | AS · PA/NP assist | $91.20 | $151.36 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $3,235.94 | Facility | None | $776.25 | $776.25 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,041.74 Typical High $3,467.37 | Facility | None | $645.65 | $2,041.74 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $6,456.54 | Professional | None | $794.33 | $1,071.52 | $6,456.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $4,677.35 | Facility | None | $912.01 | $2,454.71 | $4,677.35 |
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 $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,479.11 | Professional | None | $616.60 | $831.76 | $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 $323.59 Median $354.81 Typical High $389.05 | Professional | 52 · Reduced service | $323.59 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $158.49 | Professional | 53 · Discontinued | $131.83 | $141.25 | $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 $70.79 Typical High $79.43 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $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 8.3 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· 27th of 51
$1,072
AK $3,162TX $380
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.