How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,175 to $19,498Professionalmedian $1,148 · 10th to 90th $977 to $1,778
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 $1,174.90 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,174.90 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,348.96 | Professional | None | $1,122.02 | $1,174.90 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $10,964.78 Typical High $22,908.68 | Facility | None | $1,380.38 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,584.89 | Professional | None | $912.01 | $1,148.15 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,737.80 Typical High $2,454.71 | Professional | 50 · Both sides | $1,380.38 | $1,737.80 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $186.21 Typical High $281.84 | Professional | 80 · Assistant surgeon | $147.91 | $186.21 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $162.18 Typical High $229.09 | Professional | AS · PA/NP assist | $128.82 | $162.18 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $6,025.60 | Facility | None | $1,174.90 | $1,174.90 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,890.45 Typical High $6,606.93 | Facility | None | $776.25 | $3,890.45 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,348.96 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $6,165.95 Typical High $8,511.38 | Facility | None | $2,089.30 | $6,165.95 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,548.82 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,258.93 | $1,949.84 |
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 $562.34 Median $588.84 Typical High $676.08 | Professional | 52 · Reduced service | $562.34 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $269.15 | Professional | 53 · Discontinued | $223.87 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $870.96 Typical High $1,000.00 | Professional | 54 · Surgery only | $851.14 | $870.96 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $173.78 Typical High $199.53 | Professional | 55 · Aftercare only | $169.82 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $134.90 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $812.83 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $794.33 | $812.83 | $933.25 |
Where Indiana sits
The same service costs 6.9 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
$1,288
AK $4,786TX $692
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.