How much rates vary
Facilitymedian $4,898 · 10th to 90th $912 to $19,055Professionalmedian $776 · 10th to 90th $550 to $1,072
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 $5,011.87 Typical High $11,220.18 | Facility | None | $588.84 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $776.25 | Professional | None | $588.84 | $588.84 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $10,964.78 Typical High $22,908.68 | Facility | None | $1,122.02 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,047.13 | Professional | None | $537.03 | $776.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $489.78 Typical High $660.69 | Professional | 62 · Two surgeons | $338.84 | $489.78 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $123.03 Typical High $173.78 | Professional | 80 · Assistant surgeon | $87.10 | $123.03 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $107.15 Typical High $144.54 | Professional | AS · PA/NP assist | $75.86 | $107.15 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $5,248.07 | Facility | None | $645.65 | $645.65 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,090.30 Typical High $5,754.40 | Facility | None | $645.65 | $3,090.30 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,122.02 | Professional | None | $588.84 | $776.25 | $1,122.02 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,621.81 Median $5,370.32 Typical High $7,413.10 | Facility | None | $1,621.81 | $5,370.32 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,202.26 | Professional | None | $676.08 | $954.99 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,202.26 | Professional | None | $588.84 | $741.31 | $1,202.26 |
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 $389.05 | Professional | 52 · Reduced service | $295.12 | $295.12 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | 53 · Discontinued | $117.49 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $575.44 | Professional | 54 · Surgery only | $446.68 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $114.82 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $537.03 |
Where Indiana sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 41st of 51
$776
AK $2,570UT $479
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.