How much rates vary
Facilitymedian $3,981 · 10th to 90th $912 to $14,125Professionalmedian $832 · 10th to 90th $603 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 $645.65 Median $5,011.87 Typical High $11,220.18 | Facility | None | $645.65 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $741.31 | Professional | None | $588.84 | $645.65 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,047.13 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,122.02 | Professional | None | $602.56 | $851.14 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,288.25 Typical High $1,698.24 | Professional | 50 · Both sides | $912.01 | $1,288.25 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $134.90 Typical High $186.21 | Professional | 80 · Assistant surgeon | $95.50 | $134.90 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $120.23 Typical High $158.49 | Professional | AS · PA/NP assist | $85.11 | $120.23 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $4,265.80 | Facility | None | $707.95 | $707.95 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,570.40 Typical High $4,466.84 | Facility | None | $645.65 | $2,570.40 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $4,365.16 | Professional | None | $691.83 | $851.14 | $4,365.16 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,818.38 Typical High $5,248.07 | Facility | None | $912.01 | $2,818.38 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,380.38 | Professional | None | $691.83 | $977.24 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
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 $295.12 Median $323.59 Typical High $354.81 | Professional | 52 · Reduced service | $295.12 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $128.82 Typical High $144.54 | Professional | 53 · Discontinued | $120.23 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $446.68 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $89.13 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $58.88 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $416.87 | $457.09 | $501.19 |
Where Indiana sits
The same service costs 8.5 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· 33rd of 51
$851
AK $2,884TX $339
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.