How much rates vary
Facilitymedian $10,000 · 10th to 90th $1,175 to $38,905Professionalmedian $933 · 10th to 90th $708 to $1,413
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 $758.58 Median $5,011.87 Typical High $16,595.87 | Facility | None | $758.58 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $870.96 | Professional | None | $707.95 | $758.58 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $20,892.96 Typical High $45,708.82 | Facility | None | $1,513.56 | $20,892.96 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,258.93 | Professional | None | $707.95 | $1,000.00 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,513.56 Typical High $1,995.26 | Professional | 50 · Both sides | $1,047.13 | $1,513.56 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $630.96 Typical High $831.76 | Professional | 62 · Two surgeons | $446.68 | $630.96 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $162.18 Typical High $218.78 | Professional | 80 · Assistant surgeon | $112.20 | $162.18 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $141.25 Typical High $186.21 | Professional | AS · PA/NP assist | $97.72 | $141.25 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $13,803.84 | Facility | None | $851.14 | $851.14 | $13,803.84 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $7,762.47 Typical High $14,454.40 | Facility | None | $831.76 | $7,762.47 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $5,370.32 | Professional | None | $776.25 | $933.25 | $5,370.32 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $10,232.93 Typical High $18,620.87 | Facility | None | $912.01 | $10,232.93 | $18,620.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,621.81 | Professional | None | $794.33 | $1,148.15 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,677.35 | $12,022.64 |
United Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,445.44 | Professional | None | $660.69 | $851.14 | $1,445.44 |
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 $354.81 Median $380.19 Typical High $426.58 | Professional | 52 · Reduced service | $354.81 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $154.88 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $575.44 Typical High $630.96 | Professional | 54 · Surgery only | $524.81 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $75.86 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $537.03 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $489.78 | $537.03 | $588.84 |
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· 33rd of 51
$1,000
AK $3,388TX $209
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.