How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,148 to $14,125Professionalmedian $1,380 · 10th to 90th $933 to $2,042
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 $1,047.13 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,047.13 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,174.90 | Professional | None | $954.99 | $1,047.13 | $1,174.90 |
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 $933.25 Median $1,479.11 Typical High $1,905.46 | Professional | None | $933.25 | $1,479.11 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $2,238.72 Typical High $2,818.38 | Professional | 50 · Both sides | $1,412.54 | $2,238.72 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $933.25 Typical High $1,202.26 | Professional | 62 · Two surgeons | $588.84 | $933.25 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $239.88 Typical High $323.59 | Professional | 80 · Assistant surgeon | $151.36 | $239.88 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $208.93 Typical High $263.03 | Professional | AS · PA/NP assist | $131.83 | $208.93 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $4,365.16 | Facility | None | $1,148.15 | $1,148.15 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $4,570.88 | Facility | None | $794.33 | $2,691.53 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $8,128.31 | Professional | None | $1,148.15 | $1,513.56 | $8,128.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,235.94 Typical High $5,370.32 | Facility | None | $912.01 | $3,235.94 | $5,370.32 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,548.82 | $2,238.72 |
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 $912.01 Median $1,202.26 Typical High $2,089.30 | Professional | None | $912.01 | $1,202.26 | $2,089.30 |
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 $478.63 Median $524.81 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $208.93 Typical High $229.09 | Professional | 53 · Discontinued | $190.55 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $776.25 Typical High $870.96 | Professional | 54 · Surgery only | $724.44 | $776.25 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $173.78 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $104.71 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $724.44 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $676.08 | $724.44 | $812.83 |
Where Indiana sits
The same service costs 19.5 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
$1,479
AK $4,571TX $234
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.