How much rates vary
Facilitymedian $4,169 · 10th to 90th $933 to $14,454Professionalmedian $871 · 10th to 90th $617 to $1,230
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 $660.69 Median $5,011.87 Typical High $11,220.18 | Facility | None | $660.69 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $758.58 | Professional | None | $602.56 | $660.69 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,071.52 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $1,122.02 | Professional | None | $616.60 | $891.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $562.34 Typical High $741.31 | Professional | 62 · Two surgeons | $389.05 | $562.34 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $141.25 Typical High $194.98 | Professional | 80 · Assistant surgeon | $100.00 | $141.25 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $123.03 Typical High $165.96 | Professional | AS · PA/NP assist | $87.10 | $123.03 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,235.94 | Facility | None | $724.44 | $724.44 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,344.23 Typical High $3,548.13 | Facility | None | $630.96 | $2,344.23 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $4,897.79 | Professional | None | $724.44 | $912.01 | $4,897.79 |
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 $724.44 Median $1,000.00 Typical High $1,412.54 | Professional | None | $724.44 | $1,000.00 | $1,412.54 |
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 $575.44 Median $758.58 Typical High $1,258.93 | Professional | None | $575.44 | $758.58 | $1,258.93 |
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 $302.00 Median $331.13 Typical High $363.08 | Professional | 52 · Reduced service | $302.00 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $123.03 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $549.54 | Professional | 54 · Surgery only | $457.09 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $66.07 Typical High $74.13 | Professional | 56 · Pre-op care only | $60.26 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $467.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $426.58 | $467.74 | $512.86 |
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· 32nd of 51
$891
AK $2,951TX $347
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.