How much rates vary
Facilitymedian $10,000 · 10th to 90th $851 to $21,878Professionalmedian $1,318 · 10th to 90th $977 to $1,862
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 $1,000.00 Median $5,011.87 Typical High $17,782.79 | Facility | None | $1,000.00 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,000.00 | $1,380.38 |
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 $912.01 Median $1,318.26 Typical High $1,778.28 | Professional | None | $912.01 | $1,318.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $831.76 Typical High $1,122.02 | Professional | 62 · Two surgeons | $575.44 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $208.93 Typical High $302.00 | Professional | 80 · Assistant surgeon | $147.91 | $208.93 | $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 $1,047.13 Median $1,318.26 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,318.26 | $2,238.72 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $2,884.03 | Facility | None | $912.01 | $2,290.87 | $2,884.03 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,659.59 | $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 $1,000.00 Median $1,288.25 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,288.25 | $2,041.74 |
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 $501.19 Median $501.19 Typical High $691.83 | Professional | 52 · Reduced service | $501.19 | $501.19 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | 53 · Discontinued | $204.17 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $1,023.29 | Professional | 54 · Surgery only | $758.58 | $758.58 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $204.17 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $138.04 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $954.99 |
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· 33rd of 51
$1,318
AK $4,365TX $741
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.