How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,072 to $15,136Professionalmedian $1,259 · 10th to 90th $955 to $1,820
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 $1,047.13 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,047.13 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,174.90 | Professional | None | $954.99 | $1,047.13 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,698.24 | Professional | None | $954.99 | $1,288.25 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,949.84 Typical High $2,570.40 | Professional | 50 · Both sides | $1,412.54 | $1,949.84 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $204.17 Typical High $275.42 | Professional | 80 · Assistant surgeon | $151.36 | $204.17 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $181.97 Typical High $239.88 | Professional | AS · PA/NP assist | $131.83 | $181.97 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,897.79 Typical High $9,772.37 | Facility | None | $676.08 | $4,897.79 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $6,456.54 | Professional | None | $1,096.48 | $1,258.93 | $6,456.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,344.23 Typical High $11,481.54 | Facility | None | $912.01 | $2,344.23 | $11,481.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,548.82 | $2,187.76 |
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 $891.25 Median $1,174.90 Typical High $1,995.26 | Professional | None | $891.25 | $1,174.90 | $1,995.26 |
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 $478.63 Median $512.86 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $512.86 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $208.93 Typical High $229.09 | Professional | 53 · Discontinued | $190.55 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $776.25 Typical High $870.96 | Professional | 54 · Surgery only | $707.95 | $776.25 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $173.78 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $104.71 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $724.44 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $660.69 | $724.44 | $812.83 |
Where Indiana sits
The same service costs 8.7 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· 35th of 51
$1,288
AK $4,571TX $525
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.