How much rates vary
Facilitymedian $7,943 · 10th to 90th $832 to $19,055Professionalmedian $1,479 · 10th to 90th $1,000 to $2,188
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 $1,513.56 | Professional | None | $1,230.27 | $1,348.96 | $1,513.56 |
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 $1,479.11 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,479.11 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $2,238.72 Typical High $3,019.95 | Professional | 50 · Both sides | $1,513.56 | $2,238.72 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $933.25 Typical High $1,258.93 | Professional | 62 · Two surgeons | $630.96 | $933.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $239.88 Typical High $354.81 | Professional | 80 · Assistant surgeon | $158.49 | $239.88 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $208.93 Typical High $281.84 | Professional | AS · PA/NP assist | $141.25 | $208.93 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $1,122.02 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,479.11 | $2,398.83 |
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 $1,071.52 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,621.81 | $2,344.23 |
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 $302.00 | Professional | 53 · Discontinued | $245.47 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,000.00 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $1,000.00 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $199.53 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $134.90 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $933.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $933.25 | $1,071.52 |
Where Indiana sits
The same service costs 5.2 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· 30th of 51
$1,585
AK $4,786TX $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.