How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,148 to $14,125Professionalmedian $1,202 · 10th to 90th $813 to $1,862
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 $891.25 Median $5,011.87 Typical High $14,125.38 | Facility | None | $891.25 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,000.00 | Professional | None | $812.83 | $891.25 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,288.25 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,380.38 Typical High $1,659.59 | Professional | None | $812.83 | $1,380.38 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $2,041.74 Typical High $2,511.89 | Professional | 50 · Both sides | $1,202.26 | $2,041.74 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $851.14 Typical High $1,071.52 | Professional | 62 · Two surgeons | $512.86 | $851.14 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $218.78 Typical High $295.12 | Professional | 80 · Assistant surgeon | $128.82 | $218.78 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $190.55 Typical High $234.42 | Professional | AS · PA/NP assist | $112.20 | $190.55 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $3,235.94 | Facility | None | $977.24 | $977.24 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,454.71 Typical High $3,548.13 | Facility | None | $776.25 | $2,454.71 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $7,079.46 | Professional | None | $977.24 | $1,380.38 | $7,079.46 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,570.40 Typical High $4,677.35 | Facility | None | $912.01 | $2,570.40 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $1,905.46 | Professional | None | $977.24 | $1,348.96 | $1,905.46 |
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 $758.58 Median $1,023.29 Typical High $1,778.28 | Professional | None | $758.58 | $1,023.29 | $1,778.28 |
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 $407.38 Median $446.68 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $691.83 |
Where Indiana sits
The same service costs 16.2 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· 24th of 51
$1,380
AK $3,890TX $240
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.