How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,096 to $14,125Professionalmedian $661 · 10th to 90th $537 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 $588.84 Median $3,548.13 Typical High $14,125.38 | Facility | None | $588.84 | $3,548.13 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $831.76 | Professional | None | $588.84 | $588.84 | $831.76 |
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 $537.03 Median $741.31 Typical High $851.14 | Professional | None | $537.03 | $741.31 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,122.02 Typical High $1,258.93 | Professional | 50 · Both sides | $812.83 | $1,122.02 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $467.74 Typical High $537.03 | Professional | 62 · Two surgeons | $338.84 | $467.74 | $537.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $117.49 Typical High $154.88 | Professional | 80 · Assistant surgeon | $87.10 | $117.49 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $104.71 Typical High $117.49 | Professional | AS · PA/NP assist | $75.86 | $104.71 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $3,467.37 | Facility | None | $630.96 | $630.96 | $3,467.37 |
CareSource Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,570.40 Typical High $3,801.89 | Facility | None | $724.44 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,174.90 | Professional | None | $602.56 | $707.95 | $1,174.90 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,621.81 Median $3,630.78 Typical High $5,754.40 | Facility | None | $1,621.81 | $3,630.78 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,047.13 | Professional | None | $660.69 | $870.96 | $1,047.13 |
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 $512.86 Median $630.96 Typical High $954.99 | Professional | None | $512.86 | $630.96 | $954.99 |
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 $295.12 Typical High $407.38 | Professional | 52 · Reduced service | $295.12 | $295.12 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | 53 · Discontinued | $117.49 | $117.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | 54 · Surgery only | $446.68 | $446.68 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $575.44 |
Where Indiana sits
The same service costs 5.9 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 $2,512TX $427
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.