How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,047 to $14,125Professionalmedian $708 · 10th to 90th $513 to $1,047
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 $549.54 Median $5,011.87 Typical High $14,125.38 | Facility | None | $549.54 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $630.96 | Professional | None | $501.19 | $549.54 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $977.24 | Professional | None | $512.86 | $741.31 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,122.02 Typical High $1,479.11 | Professional | 50 · Both sides | $776.25 | $1,122.02 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $467.74 Typical High $616.60 | Professional | 62 · Two surgeons | $323.59 | $467.74 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $120.23 Typical High $165.96 | Professional | 80 · Assistant surgeon | $83.18 | $120.23 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $104.71 Typical High $138.04 | Professional | AS · PA/NP assist | $72.44 | $104.71 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $3,235.94 | Facility | None | $602.56 | $602.56 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,454.71 Typical High $3,548.13 | Facility | None | $776.25 | $2,454.71 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $3,801.89 | Professional | None | $588.84 | $724.44 | $3,801.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $4,677.35 | Facility | None | $912.01 | $2,454.71 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,174.90 | Professional | None | $616.60 | $831.76 | $1,174.90 |
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 $467.74 Median $616.60 Typical High $1,023.29 | Professional | None | $467.74 | $616.60 | $1,023.29 |
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 $251.19 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $251.19 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $100.00 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $380.19 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $50.12 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $426.58 |
Where Indiana sits
The same service costs 14.1 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
$741
AK $2,455TX $174
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.