How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,259 to $28,840Professionalmedian $1,230 · 10th to 90th $871 to $1,778
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 $954.99 Median $5,011.87 Typical High $16,595.87 | Facility | None | $954.99 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,096.48 | Professional | None | $891.25 | $954.99 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,698.24 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $1,659.59 | Professional | None | $870.96 | $1,318.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,995.26 Typical High $2,630.27 | Professional | 50 · Both sides | $1,318.26 | $1,995.26 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $208.93 Typical High $281.84 | Professional | 80 · Assistant surgeon | $141.25 | $208.93 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $186.21 Typical High $245.47 | Professional | AS · PA/NP assist | $123.03 | $186.21 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $10,232.93 | Facility | None | $1,047.13 | $1,047.13 | $10,232.93 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $3,801.89 Typical High $10,964.78 | Facility | None | $912.01 | $3,801.89 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $6,918.31 | Professional | None | $1,047.13 | $1,288.25 | $6,918.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $5,248.07 Typical High $12,882.50 | Facility | None | $912.01 | $5,248.07 | $12,882.50 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,445.44 | $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 $831.76 Median $1,096.48 Typical High $1,819.70 | Professional | None | $831.76 | $1,096.48 | $1,819.70 |
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 $478.63 Typical High $537.03 | Professional | 52 · Reduced service | $436.52 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $213.80 | Professional | 53 · Discontinued | $177.83 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $660.69 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $144.54 Typical High $158.49 | Professional | 55 · Aftercare only | $131.83 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $107.15 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $676.08 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $616.60 | $676.08 | $741.31 |
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· 32nd of 51
$1,318
AK $4,266TX $537
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.