How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,023 to $14,454Professionalmedian $4,365 · 10th to 90th $3,162 to $6,607
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 $1,380.38 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,380.38 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,548.13 Typical High $3,890.45 | Professional | None | $3,162.28 | $3,548.13 | $3,890.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,230.27 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $4,897.79 Typical High $6,165.95 | Professional | None | $3,162.28 | $4,897.79 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,677.35 Median $7,244.36 Typical High $9,332.54 | Professional | 50 · Both sides | $4,677.35 | $7,244.36 | $9,332.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,995.26 Median $3,090.30 Typical High $3,981.07 | Professional | 62 · Two surgeons | $1,995.26 | $3,090.30 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $776.25 Typical High $1,047.13 | Professional | 80 · Assistant surgeon | $501.19 | $776.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $436.52 Median $676.08 Typical High $870.96 | Professional | AS · PA/NP assist | $436.52 | $676.08 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $1,230.27 Typical High $3,890.45 | Facility | None | $831.76 | $1,230.27 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,025.60 Typical High $10,000.00 | Facility | None | $645.65 | $6,025.60 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $21,877.62 | Professional | None | $3,630.78 | $4,466.84 | $21,877.62 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $7,079.46 Typical High $11,481.54 | Facility | None | $912.01 | $7,079.46 | $11,481.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $7,413.10 | Professional | None | $3,801.89 | $5,248.07 | $7,413.10 |
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 $3,090.30 Median $3,801.89 Typical High $6,606.93 | Professional | None | $3,090.30 | $3,801.89 | $6,606.93 |
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 $1,621.81 Median $1,778.28 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,621.81 | $1,778.28 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $707.95 Typical High $776.25 | Professional | 53 · Discontinued | $645.65 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,630.27 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,398.83 | $2,630.27 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $524.81 Typical High $588.84 | Professional | 55 · Aftercare only | $478.63 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $354.81 Typical High $389.05 | Professional | 56 · Pre-op care only | $323.59 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,454.71 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,454.71 | $2,754.23 |
Where Indiana sits
The same service costs 20.4 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· 27th of 51
$4,571
AK $15,488TX $759
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.