How much rates vary
Facilitymedian $4,074 · 10th to 90th $955 to $14,125Professionalmedian $1,122 · 10th to 90th $851 to $1,660
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 $954.99 Median $5,011.87 Typical High $11,220.18 | Facility | None | $954.99 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,071.52 | Professional | None | $851.14 | $954.99 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,096.48 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,479.11 | Professional | None | $831.76 | $1,122.02 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,659.59 Typical High $2,187.76 | Professional | 50 · Both sides | $1,258.93 | $1,659.59 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $177.83 Typical High $251.19 | Professional | 80 · Assistant surgeon | $138.04 | $177.83 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $154.88 Typical High $204.17 | Professional | AS · PA/NP assist | $117.49 | $154.88 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $3,235.94 | Facility | None | $1,023.29 | $1,023.29 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,041.74 Typical High $3,467.37 | Facility | None | $645.65 | $2,041.74 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $5,754.40 | Professional | None | $954.99 | $1,230.27 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,754.23 Typical High $4,677.35 | Facility | None | $912.01 | $2,754.23 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,412.54 | $1,995.26 |
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 $812.83 Median $1,023.29 Typical High $1,862.09 | Professional | None | $812.83 | $1,023.29 | $1,862.09 |
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 $426.58 Median $478.63 Typical High $489.78 | Professional | 52 · Reduced service | $426.58 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $190.55 Typical High $194.98 | Professional | 53 · Discontinued | $169.82 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $707.95 Typical High $741.31 | Professional | 54 · Surgery only | $645.65 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $147.91 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $95.50 Typical High $97.72 | Professional | 56 · Pre-op care only | $85.11 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $660.69 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $602.56 | $660.69 | $691.83 |
Where Indiana sits
The same service costs 7.6 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· 34th of 51
$1,122
AK $3,981TX $525
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.