How much rates vary
Facilitymedian $9,120 · 10th to 90th $1,259 to $39,811Professionalmedian $1,585 · 10th to 90th $1,072 to $2,291
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 $1,288.25 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,288.25 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,288.25 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,513.56 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,737.80 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $1,071.52 Typical High $1,445.44 | Professional | 62 · Two surgeons | $676.08 | $1,071.52 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $275.42 Typical High $380.19 | Professional | 80 · Assistant surgeon | $169.82 | $275.42 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $239.88 Typical High $316.23 | Professional | AS · PA/NP assist | $147.91 | $239.88 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,168.69 Typical High $6,918.31 | Facility | None | $645.65 | $4,168.69 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,584.89 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $4,677.35 Typical High $10,715.19 | Facility | None | $954.99 | $4,677.35 | $10,715.19 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,584.89 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,513.56 | $2,344.23 |
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 $588.84 Median $645.65 Typical High $758.58 | Professional | 52 · Reduced service | $588.84 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $309.03 | Professional | 53 · Discontinued | $234.42 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $891.25 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $154.88 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $1,071.52 |
Where Indiana sits
The same service costs 6.9 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
$1,738
AK $5,370TX $776
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.