How much rates vary
Facilitymedian $5,623 · 10th to 90th $692 to $25,119Professionalmedian $3,236 · 10th to 90th $2,089 to $4,677
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 $2,344.23 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,344.23 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $2,951.21 | Professional | None | $2,398.83 | $2,630.27 | $2,951.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $12,022.64 Typical High $28,840.32 | Facility | None | $1,621.81 | $12,022.64 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $3,467.37 Typical High $4,677.35 | Professional | None | $1,995.26 | $3,467.37 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $2,187.76 Typical High $2,951.21 | Professional | 62 · Two surgeons | $1,230.27 | $2,187.76 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $549.54 Typical High $831.76 | Professional | 80 · Assistant surgeon | $316.23 | $549.54 | $831.76 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $478.63 Typical High $645.65 | Professional | AS · PA/NP assist | $275.42 | $478.63 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,511.89 Typical High $4,897.79 | Facility | None | $562.34 | $2,511.89 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $3,162.28 Typical High $4,786.30 | Professional | None | $2,238.72 | $3,162.28 | $4,786.30 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,951.21 Typical High $6,025.60 | Facility | None | $912.01 | $2,951.21 | $6,025.60 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $3,890.45 | Professional | None | $2,454.71 | $2,884.03 | $3,890.45 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $4,466.84 | Professional | None | $2,290.87 | $3,162.28 | $4,466.84 |
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 $1,202.26 Median $1,318.26 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,202.26 | $1,318.26 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $524.81 Typical High $588.84 | Professional | 53 · Discontinued | $478.63 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,949.84 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,778.28 | $1,949.84 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $398.11 Typical High $436.52 | Professional | 55 · Aftercare only | $354.81 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $263.03 Typical High $295.12 | Professional | 56 · Pre-op care only | $239.88 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,819.70 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,819.70 | $2,041.74 |
Where Indiana sits
The same service costs 5.8 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· 17th of 51
$3,467
AK $9,333TX $1,622
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.