How much rates vary
Facilitymedian $3,631 · 10th to 90th $794 to $8,913Professionalmedian $501 · 10th to 90th $372 to $708
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 $426.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $426.58 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $512.86 | Professional | None | $389.05 | $426.58 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $5,248.07 Typical High $9,549.93 | Facility | None | $891.25 | $5,248.07 | $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 62 · Two surgeons Typical Low $229.09 Median $316.23 Typical High $436.52 | Professional | 62 · Two surgeons | $229.09 | $316.23 | $436.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $79.43 Typical High $114.82 | Professional | 80 · Assistant surgeon | $57.54 | $79.43 | $114.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $70.79 Typical High $95.50 | Professional | AS · PA/NP assist | $50.12 | $70.79 | $95.50 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $3,467.37 | Facility | None | $446.68 | $446.68 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,089.30 Typical High $3,715.35 | Facility | None | $501.19 | $2,089.30 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $691.83 | Professional | None | $407.38 | $512.86 | $691.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,096.48 Median $3,548.13 Typical High $4,570.88 | Facility | None | $1,096.48 | $3,548.13 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $794.33 | Professional | None | $436.52 | $537.03 | $794.33 |
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 $389.05 Median $489.78 Typical High $758.58 | Professional | None | $389.05 | $489.78 | $758.58 |
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 $194.98 Median $213.80 Typical High $257.04 | Professional | 52 · Reduced service | $194.98 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $87.10 Typical High $102.33 | Professional | 53 · Discontinued | $77.62 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $389.05 | Professional | 54 · Surgery only | $295.12 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $77.62 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $363.08 |
Where Indiana sits
The same service costs 7.1 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
$525
AK $2,042UT $288
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.