How much rates vary
Facilitymedian $3,631 · 10th to 90th $741 to $8,318Professionalmedian $501 · 10th to 90th $372 to $741
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 $416.87 Median $5,011.87 Typical High $5,623.41 | Facility | None | $416.87 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $537.03 | Professional | None | $416.87 | $416.87 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $676.08 | Professional | None | $363.08 | $501.19 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $758.58 Typical High $1,047.13 | Professional | 50 · Both sides | $549.54 | $758.58 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $81.28 Typical High $117.49 | Professional | 80 · Assistant surgeon | $58.88 | $81.28 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $70.79 Typical High $95.50 | Professional | AS · PA/NP assist | $51.29 | $70.79 | $95.50 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $1,995.26 | Facility | None | $436.52 | $436.52 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,445.44 Typical High $2,187.76 | Facility | None | $407.38 | $1,445.44 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $870.96 | Professional | None | $398.11 | $524.81 | $870.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,096.48 Median $2,137.96 Typical High $3,311.31 | Facility | None | $1,096.48 | $2,137.96 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $812.83 | Professional | None | $436.52 | $537.03 | $812.83 |
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 $398.11 Median $501.19 Typical High $794.33 | Professional | None | $398.11 | $501.19 | $794.33 |
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 $208.93 Median $208.93 Typical High $245.47 | Professional | 52 · Reduced service | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | 53 · Discontinued | $83.18 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $371.54 | Professional | 54 · Surgery only | $309.03 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $74.13 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $50.12 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $346.74 |
Where Indiana sits
The same service costs 5.1 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
$513
AK $1,698UT $331
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.