How much rates vary
Facilitymedian $3,981 · 10th to 90th $759 to $14,125Professionalmedian $646 · 10th to 90th $447 to $891
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 $489.78 Median $5,011.87 Typical High $5,623.41 | Facility | None | $489.78 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $602.56 | Professional | None | $489.78 | $489.78 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $7,413.10 Typical High $17,378.01 | Facility | None | $741.31 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $870.96 | Professional | None | $426.58 | $645.65 | $870.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $977.24 Typical High $1,318.26 | Professional | 50 · Both sides | $645.65 | $977.24 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $407.38 Typical High $549.54 | Professional | 62 · Two surgeons | $269.15 | $407.38 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $102.33 Typical High $147.91 | Professional | 80 · Assistant surgeon | $69.18 | $102.33 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $91.20 Typical High $123.03 | Professional | AS · PA/NP assist | $60.26 | $91.20 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $3,467.37 | Facility | None | $512.86 | $512.86 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $2,238.72 Typical High $3,715.35 | Facility | None | $407.38 | $2,238.72 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,023.29 | Professional | None | $478.63 | $630.96 | $1,023.29 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,288.25 Median $3,548.13 Typical High $5,011.87 | Facility | None | $1,288.25 | $3,548.13 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $954.99 | Professional | None | $512.86 | $630.96 | $954.99 |
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 $478.63 Median $602.56 Typical High $933.25 | Professional | None | $478.63 | $602.56 | $933.25 |
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 $245.47 Median $245.47 Typical High $302.00 | Professional | 52 · Reduced service | $245.47 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | 53 · Discontinued | $97.72 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $457.09 | Professional | 54 · Surgery only | $371.54 | $371.54 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $91.20 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $60.26 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $426.58 |
Where Indiana sits
The same service costs 5.5 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· 37th of 51
$646
AK $2,042UT $372
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.