How much rates vary
Facilitymedian $3,236 · 10th to 90th $468 to $14,125Professionalmedian $589 · 10th to 90th $339 to $933
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 $363.08 Median $588.84 Typical High $5,011.87 | Facility | None | $363.08 | $588.84 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $707.95 | Professional | None | $363.08 | $512.86 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $416.87 | Professional | None | $257.04 | $338.84 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,288.25 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $630.96 Typical High $933.25 | Professional | None | $275.42 | $630.96 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $954.99 Typical High $1,380.38 | Professional | 50 · Both sides | $407.38 | $954.99 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $173.78 Median $398.11 Typical High $588.84 | Professional | 62 · Two surgeons | $173.78 | $398.11 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $478.63 | Facility | None | $338.84 | $338.84 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $512.86 Typical High $1,584.89 | Facility | None | $309.03 | $512.86 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $630.96 Typical High $1,096.48 | Professional | None | $338.84 | $630.96 | $1,096.48 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $457.09 Median $870.96 Typical High $4,570.88 | Facility | None | $457.09 | $870.96 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $346.74 Median $575.44 Typical High $794.33 | Professional | None | $346.74 | $575.44 | $794.33 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $977.24 | Professional | None | $398.11 | $616.60 | $977.24 |
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 $186.21 Median $239.88 Typical High $302.00 | Professional | 52 · Reduced service | $186.21 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $95.50 Typical High $120.23 | Professional | 53 · Discontinued | $74.13 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $363.08 Typical High $446.68 | Professional | 54 · Surgery only | $281.84 | $363.08 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $72.44 Typical High $89.13 | Professional | 55 · Aftercare only | $56.23 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $47.86 Typical High $60.26 | Professional | 56 · Pre-op care only | $37.15 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $338.84 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $263.03 | $338.84 | $416.87 |
Where Indiana sits
The same service costs 4.3 times more in Wisconsin 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· 33rd of 51
$661
WI $1,862TX $437
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.