How much rates vary
Facilitymedian $5,248 · 10th to 90th $955 to $14,125Professionalmedian $1,259 · 10th to 90th $851 to $1,905
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 $933.25 Median $5,011.87 Typical High $11,220.18 | Facility | None | $933.25 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,047.13 | Professional | None | $870.96 | $933.25 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,096.48 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,380.38 Typical High $1,698.24 | Professional | None | $851.14 | $1,380.38 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $2,089.30 Typical High $2,570.40 | Professional | 50 · Both sides | $1,288.25 | $2,089.30 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $218.78 Typical High $295.12 | Professional | 80 · Assistant surgeon | $138.04 | $218.78 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $194.98 Typical High $239.88 | Professional | AS · PA/NP assist | $120.23 | $194.98 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $7,244.36 | Facility | None | $1,047.13 | $1,047.13 | $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 $1,047.13 Median $1,348.96 Typical High $7,079.46 | Professional | None | $1,047.13 | $1,348.96 | $7,079.46 |
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 $1,023.29 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,412.54 | $2,041.74 |
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 $812.83 Median $1,122.02 Typical High $1,905.46 | Professional | None | $812.83 | $1,122.02 | $1,905.46 |
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 $436.52 Median $467.74 Typical High $524.81 | Professional | 52 · Reduced service | $436.52 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $186.21 Typical High $208.93 | Professional | 53 · Discontinued | $173.78 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $707.95 Typical High $776.25 | Professional | 54 · Surgery only | $645.65 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $660.69 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $602.56 | $660.69 | $724.44 |
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· 29th of 51
$1,380
AK $4,169TX $501
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.