How much rates vary
Facilitymedian $11,220 · 10th to 90th $1,175 to $39,811Professionalmedian $1,318 · 10th to 90th $1,023 to $2,042
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 $1,202.26 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,202.26 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,318.26 | Professional | None | $1,000.00 | $1,202.26 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $20,892.96 Typical High $45,708.82 | Facility | None | $1,412.54 | $20,892.96 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,318.26 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,949.84 Typical High $2,630.27 | Professional | 50 · Both sides | $1,548.82 | $1,949.84 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $831.76 Typical High $1,122.02 | Professional | 62 · Two surgeons | $660.69 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $208.93 Typical High $295.12 | Professional | 80 · Assistant surgeon | $165.96 | $208.93 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $181.97 Typical High $245.47 | Professional | AS · PA/NP assist | $144.54 | $181.97 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $19,498.45 | Facility | None | $1,318.26 | $1,318.26 | $19,498.45 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $11,481.54 Typical High $19,054.61 | Facility | None | $776.25 | $11,481.54 | $19,054.61 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $7,943.28 | Professional | None | $1,258.93 | $1,479.11 | $7,943.28 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $13,489.63 Typical High $23,988.33 | Facility | None | $912.01 | $13,489.63 | $23,988.33 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,318.26 | $1,819.70 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,318.26 | $2,238.72 |
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 $549.54 Median $602.56 Typical High $660.69 | Professional | 52 · Reduced service | $549.54 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $263.03 | Professional | 53 · Discontinued | $218.78 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $912.01 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $912.01 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $181.97 Typical High $199.53 | Professional | 55 · Aftercare only | $165.96 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $120.23 Typical High $131.83 | Professional | 56 · Pre-op care only | $109.65 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $851.14 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $776.25 | $851.14 | $933.25 |
Where Indiana sits
The same service costs 7.4 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· 42nd of 51
$1,318
AK $5,248TX $708
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.