How much rates vary
Facilitymedian $3,890 · 10th to 90th $977 to $10,000Professionalmedian $692 · 10th to 90th $525 to $977
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 $602.56 Median $5,011.87 Typical High $14,125.38 | Facility | None | $602.56 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $831.76 | Professional | None | $588.84 | $602.56 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $9,549.93 | Facility | None | $1,174.90 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $758.58 Typical High $870.96 | Professional | None | $501.19 | $758.58 | $870.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $478.63 Typical High $549.54 | Professional | 62 · Two surgeons | $316.23 | $478.63 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $120.23 Typical High $158.49 | Professional | 80 · Assistant surgeon | $79.43 | $120.23 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $107.15 Typical High $120.23 | Professional | AS · PA/NP assist | $70.79 | $107.15 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $2,884.03 | Facility | None | $616.60 | $616.60 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,778.28 Typical High $3,311.31 | Facility | None | $707.95 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,202.26 | Professional | None | $575.44 | $691.83 | $1,202.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,513.56 Median $2,951.21 Typical High $6,025.60 | Facility | None | $1,513.56 | $2,951.21 | $6,025.60 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,071.52 | Professional | None | $616.60 | $851.14 | $1,071.52 |
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 $524.81 Median $645.65 Typical High $1,000.00 | Professional | None | $524.81 | $645.65 | $1,000.00 |
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 $295.12 Median $302.00 Typical High $407.38 | Professional | 52 · Reduced service | $295.12 | $302.00 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $120.23 Typical High $162.18 | Professional | 53 · Discontinued | $117.49 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $602.56 | Professional | 54 · Surgery only | $446.68 | $446.68 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $91.20 Typical High $120.23 | Professional | 55 · Aftercare only | $89.13 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $60.26 Typical High $81.28 | Professional | 56 · Pre-op care only | $58.88 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $562.34 |
Where Indiana sits
The same service costs 6.5 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
$708
AK $2,455TX $380
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.