How much rates vary
Facilitymedian $4,074 · 10th to 90th $912 to $14,125Professionalmedian $955 · 10th to 90th $741 to $1,413
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 $812.83 Median $5,011.87 Typical High $11,220.18 | Facility | None | $812.83 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $891.25 | Professional | None | $724.44 | $812.83 | $891.25 |
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 $776.25 Median $954.99 Typical High $1,258.93 | Professional | None | $776.25 | $954.99 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,412.54 Typical High $1,905.46 | Professional | 50 · Both sides | $1,174.90 | $1,412.54 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $151.36 Typical High $213.80 | Professional | 80 · Assistant surgeon | $123.03 | $151.36 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $131.83 Typical High $177.83 | Professional | AS · PA/NP assist | $109.65 | $131.83 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $3,235.94 | Facility | None | $870.96 | $870.96 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,995.26 Typical High $3,467.37 | Facility | None | $645.65 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $5,754.40 | Professional | None | $851.14 | $1,071.52 | $5,754.40 |
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 $758.58 Median $1,230.27 Typical High $1,737.80 | Professional | None | $758.58 | $1,230.27 | $1,737.80 |
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 $676.08 Median $891.25 Typical High $1,479.11 | Professional | None | $676.08 | $891.25 | $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 $363.08 Median $407.38 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $162.18 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $616.60 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $123.03 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $575.44 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $501.19 | $575.44 | $616.60 |
Where Indiana sits
The same service costs 7.9 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· 37th of 51
$955
AK $3,548TX $447
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.