How much rates vary
Facilitymedian $4,898 · 10th to 90th $955 to $15,136Professionalmedian $813 · 10th to 90th $617 to $1,175
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 $660.69 Median $3,467.37 Typical High $5,011.87 | Facility | None | $660.69 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $741.31 | Professional | None | $602.56 | $660.69 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,148.15 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,071.52 | Professional | None | $630.96 | $812.83 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,230.27 Typical High $1,659.59 | Professional | 50 · Both sides | $933.25 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $131.83 Typical High $181.97 | Professional | 80 · Assistant surgeon | $100.00 | $131.83 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $114.82 Typical High $154.88 | Professional | AS · PA/NP assist | $87.10 | $114.82 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,041.74 Typical High $3,467.37 | Facility | None | $676.08 | $2,041.74 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $4,466.84 | Professional | None | $691.83 | $851.14 | $4,466.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,949.84 Typical High $9,120.11 | Facility | None | $912.01 | $1,949.84 | $9,120.11 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,412.54 | Professional | None | $660.69 | $1,000.00 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,202.26 | Professional | None | $562.34 | $707.95 | $1,202.26 |
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 $302.00 Median $331.13 Typical High $363.08 | Professional | 52 · Reduced service | $302.00 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $120.23 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $549.54 | Professional | 54 · Surgery only | $457.09 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $66.07 Typical High $72.44 | Professional | 56 · Pre-op care only | $60.26 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $467.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $426.58 | $467.74 | $512.86 |
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· 36th of 51
$813
AK $2,951TX $151
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.