How much rates vary
Facilitymedian $7,943 · 10th to 90th $832 to $19,055Professionalmedian $1,660 · 10th to 90th $1,096 to $2,291
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 $1,348.96 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,348.96 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,230.27 | $1,348.96 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $10,964.78 Typical High $22,387.21 | Facility | None | $1,862.09 | $10,964.78 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $2,454.71 Typical High $3,311.31 | Professional | 50 · Both sides | $1,513.56 | $2,454.71 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $1,047.13 Typical High $1,412.54 | Professional | 62 · Two surgeons | $630.96 | $1,047.13 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $263.03 Typical High $398.11 | Professional | 80 · Assistant surgeon | $162.18 | $263.03 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $229.09 Typical High $309.03 | Professional | AS · PA/NP assist | $141.25 | $229.09 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,698.24 | $2,630.27 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,090.30 | Facility | None | $912.01 | $2,290.87 | $3,090.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,479.11 | $1,995.26 |
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 $1,148.15 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,659.59 | $2,398.83 |
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 $616.60 Median $676.08 Typical High $758.58 | Professional | 52 · Reduced service | $616.60 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | 53 · Discontinued | $245.47 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,023.29 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $134.90 Typical High $154.88 | Professional | 56 · Pre-op care only | $123.03 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $954.99 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $954.99 | $1,071.52 |
Where Indiana sits
The same service costs 5.4 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· 32nd of 51
$1,660
AK $4,898TX $912
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.