How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,047 to $14,454Professionalmedian $891 · 10th to 90th $631 to $1,259
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 $691.83 Median $5,011.87 Typical High $14,125.38 | Facility | None | $691.83 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $912.01 | Professional | None | $691.83 | $691.83 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,230.27 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,202.26 | Professional | None | $602.56 | $891.25 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,318.26 Typical High $1,819.70 | Professional | 50 · Both sides | $912.01 | $1,318.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $141.25 Typical High $199.53 | Professional | 80 · Assistant surgeon | $97.72 | $141.25 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $123.03 Typical High $169.82 | Professional | AS · PA/NP assist | $85.11 | $123.03 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,467.37 | Facility | None | $724.44 | $724.44 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,570.40 Typical High $3,801.89 | Facility | None | $645.65 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,445.44 | Professional | None | $676.08 | $870.96 | $1,445.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,162.28 Typical High $5,128.61 | Facility | None | $954.99 | $3,162.28 | $5,128.61 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,348.96 | Professional | None | $724.44 | $891.25 | $1,348.96 |
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 $676.08 Median $851.14 Typical High $1,288.25 | Professional | None | $676.08 | $851.14 | $1,288.25 |
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 $346.74 Median $346.74 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 53 · Discontinued | $141.25 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $630.96 | Professional | 54 · Surgery only | $524.81 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $588.84 |
Where Indiana sits
The same service costs 6.3 times more in Oklahoma 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· 36th of 51
$891
OK $3,311UT $525
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.