How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,023 to $30,200Professionalmedian $794 · 10th to 90th $575 to $1,148
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 $616.60 Median $5,011.87 Typical High $14,125.38 | Facility | None | $616.60 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $707.95 | Professional | None | $562.34 | $616.60 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $16,982.44 Typical High $34,673.69 | Facility | None | $2,137.96 | $16,982.44 | $34,673.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,096.48 | Professional | None | $575.44 | $831.76 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,258.93 Typical High $1,659.59 | Professional | 50 · Both sides | $870.96 | $1,258.93 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $524.81 Typical High $691.83 | Professional | 62 · Two surgeons | $363.08 | $524.81 | $691.83 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $7,244.36 | Facility | None | $676.08 | $676.08 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $4,265.80 Typical High $7,762.47 | Facility | None | $660.69 | $4,265.80 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $4,365.16 | Professional | None | $660.69 | $812.83 | $4,365.16 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $5,248.07 Typical High $10,471.29 | Facility | None | $912.01 | $5,248.07 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,318.26 | Professional | None | $676.08 | $933.25 | $1,318.26 |
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 $537.03 Median $707.95 Typical High $1,174.90 | Professional | None | $537.03 | $707.95 | $1,174.90 |
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 $281.84 Median $309.03 Typical High $338.84 | Professional | 52 · Reduced service | $281.84 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $134.90 | Professional | 53 · Discontinued | $112.20 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $93.33 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $61.66 Typical High $67.61 | Professional | 56 · Pre-op care only | $56.23 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $436.52 | $478.63 |
Where Indiana sits
The same service costs 8.1 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· 31st of 51
$832
AK $2,754TX $339
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.