How much rates vary
Facilitymedian $3,715 · 10th to 90th $661 to $8,318Professionalmedian $355 · 10th to 90th $251 to $501
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 $281.84 Median $331.13 Typical High $5,623.41 | Facility | None | $281.84 | $331.13 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $331.13 | Professional | None | $257.04 | $281.84 | $331.13 |
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 $234.42 Median $363.08 Typical High $489.78 | Professional | None | $234.42 | $363.08 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $549.54 Typical High $741.31 | Professional | 50 · Both sides | $354.81 | $549.54 | $741.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $147.91 Median $229.09 Typical High $309.03 | Professional | 62 · Two surgeons | $147.91 | $229.09 | $309.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.02 Median $58.88 Typical High $83.18 | Professional | 80 · Assistant surgeon | $38.02 | $58.88 | $83.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $51.29 Typical High $69.18 | Professional | AS · PA/NP assist | $33.11 | $51.29 | $69.18 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $3,467.37 | Facility | None | $295.12 | $295.12 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,570.40 Typical High $3,801.89 | Facility | None | $630.96 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $562.34 | Professional | None | $275.42 | $354.81 | $562.34 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $776.25 Median $3,548.13 Typical High $4,570.88 | Facility | None | $776.25 | $3,548.13 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $524.81 | Professional | None | $281.84 | $354.81 | $524.81 |
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 $263.03 Median $323.59 Typical High $512.86 | Professional | None | $263.03 | $323.59 | $512.86 |
7 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 $128.82 Median $141.25 Typical High $165.96 | Professional | 52 · Reduced service | $128.82 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $67.61 | Professional | 53 · Discontinued | $51.29 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $251.19 | Professional | 54 · Surgery only | $194.98 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $50.12 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.18 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.70 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $234.42 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 51 · Multiple procedures | $323.59 | $323.59 | $323.59 |
Where Indiana sits
The same service costs 6.0 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· 41st of 51
$363
OK $1,479UT $245
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.