How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,047 to $14,125Professionalmedian $1,820 · 10th to 90th $1,288 to $2,630
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 $1,318.26 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,412.54 | $1,621.81 |
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 $1,288.25 Median $1,905.46 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,905.46 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,884.03 Typical High $3,801.89 | Professional | 50 · Both sides | $1,905.46 | $2,884.03 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $309.03 Typical High $416.87 | Professional | 80 · Assistant surgeon | $204.17 | $309.03 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $269.15 Typical High $354.81 | Professional | AS · PA/NP assist | $177.83 | $269.15 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,691.53 Typical High $4,365.16 | Facility | None | $676.08 | $2,691.53 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $9,772.37 | Professional | None | $1,513.56 | $1,819.70 | $9,772.37 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,162.28 Typical High $5,248.07 | Facility | None | $912.01 | $3,162.28 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $3,019.95 | Professional | None | $1,548.82 | $2,137.96 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $4,168.69 Typical High $9,120.11 | Facility | None | $1,096.48 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,659.59 | $2,754.23 |
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 $660.69 Median $707.95 Typical High $794.33 | Professional | 52 · Reduced service | $660.69 | $707.95 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $316.23 | Professional | 53 · Discontinued | $263.03 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,071.52 Typical High $1,174.90 | Professional | 54 · Surgery only | $977.24 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $213.80 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $158.49 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,000.00 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $912.01 | $1,000.00 | $1,096.48 |
Where Indiana sits
The same service costs 16.2 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· 30th of 51
$1,905
AK $6,310TX $389
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.