How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $11,482Professionalmedian $550 · 10th to 90th $389 to $776
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 $3,467.37 Typical High $5,011.87 | Facility | None | $416.87 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $512.86 | Professional | None | $389.05 | $416.87 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $7,079.46 Typical High $11,481.54 | Facility | None | $1,380.38 | $7,079.46 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $741.31 | Professional | None | $380.19 | $549.54 | $741.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $346.74 Typical High $467.74 | Professional | 62 · Two surgeons | $234.42 | $346.74 | $467.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $89.13 Typical High $125.89 | Professional | 80 · Assistant surgeon | $60.26 | $89.13 | $125.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $77.62 Typical High $104.71 | Professional | AS · PA/NP assist | $52.48 | $77.62 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $2,691.53 | Facility | None | $524.81 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $912.01 | Professional | None | $467.74 | $562.34 | $912.01 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,148.15 Typical High $2,187.76 | Facility | None | $912.01 | $1,148.15 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $812.83 | Professional | None | $457.09 | $562.34 | $812.83 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $851.14 | Professional | None | $446.68 | $562.34 | $851.14 |
5 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 $208.93 Typical High $257.04 | Professional | 52 · Reduced service | $194.98 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $83.18 Typical High $102.33 | Professional | 53 · Discontinued | $77.62 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $309.03 Typical High $380.19 | Professional | 54 · Surgery only | $288.40 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $77.62 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $41.69 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.90 | $41.69 | $51.29 |
Where Indiana sits
The same service costs 3.4 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
$562
AK $1,514UT $447
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.