How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,175 to $15,136Professionalmedian $1,349 · 10th to 90th $1,096 to $2,239
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 $16,595.87 | Facility | None | $1,380.38 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,412.54 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,288.25 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,949.84 Typical High $2,630.27 | Professional | 50 · Both sides | $1,621.81 | $1,949.84 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $812.83 Typical High $1,096.48 | Professional | 62 · Two surgeons | $676.08 | $812.83 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $208.93 Typical High $295.12 | Professional | 80 · Assistant surgeon | $173.78 | $208.93 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $181.97 Typical High $245.47 | Professional | AS · PA/NP assist | $151.36 | $181.97 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,187.76 Typical High $3,467.37 | Facility | None | $676.08 | $2,187.76 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $7,413.10 | Professional | None | $1,148.15 | $1,584.89 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,715.35 Typical High $9,120.11 | Facility | None | $954.99 | $3,715.35 | $9,120.11 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,445.44 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,445.44 | $2,089.30 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $2,691.53 | Professional | None | $977.24 | $1,479.11 | $2,691.53 |
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 $645.65 Median $707.95 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $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 $234.42 | Professional | 55 · Aftercare only | $194.98 | $213.80 | $234.42 |
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 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· 43rd of 51
$1,413
AK $6,166TX $724
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.