How much rates vary
Facilitymedian $9,772 · 10th to 90th $832 to $21,878Professionalmedian $1,318 · 10th to 90th $933 to $1,820
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 $977.24 Median $3,467.37 Typical High $5,011.87 | Facility | None | $977.24 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,318.26 | Professional | None | $977.24 | $977.24 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $14,454.40 Typical High $22,908.68 | Facility | None | $1,862.09 | $14,454.40 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $1,778.28 | Professional | None | $933.25 | $1,318.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,995.26 Typical High $2,691.53 | Professional | 50 · Both sides | $1,380.38 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $831.76 Typical High $1,122.02 | Professional | 62 · Two surgeons | $588.84 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $213.80 Typical High $302.00 | Professional | 80 · Assistant surgeon | $147.91 | $213.80 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $186.21 Typical High $251.19 | Professional | AS · PA/NP assist | $128.82 | $186.21 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $1,023.29 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,288.25 | $1,995.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $2,818.38 | Facility | None | $912.01 | $2,290.87 | $2,818.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,621.81 | $2,041.74 |
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 $933.25 Median $1,230.27 Typical High $1,905.46 | Professional | None | $933.25 | $1,230.27 | $1,905.46 |
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 $489.78 Median $489.78 Typical High $660.69 | Professional | 52 · Reduced service | $489.78 | $489.78 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $263.03 | Professional | 53 · Discontinued | $199.53 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $977.24 | Professional | 54 · Surgery only | $741.31 | $741.31 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $194.98 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $912.01 |
Where Indiana sits
The same service costs 6.6 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· 34th of 51
$1,318
AK $4,365TX $661
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.