How much rates vary
Facilitymedian $3,236 · 10th to 90th $617 to $8,913Professionalmedian $316 · 10th to 90th $214 to $724
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 $562.34 Median $5,011.87 Typical High $5,623.41 | Facility | None | $562.34 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $616.60 | Professional | None | $524.81 | $562.34 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $933.25 Typical High $1,819.70 | Facility | None | $275.42 | $933.25 | $1,819.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $363.08 | Professional | None | $213.80 | $275.42 | $363.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $416.87 Typical High $562.34 | Professional | 50 · Both sides | $316.23 | $416.87 | $562.34 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $131.83 Median $173.78 Typical High $234.42 | Professional | 62 · Two surgeons | $131.83 | $173.78 | $234.42 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $44.67 Typical High $61.66 | Professional | 80 · Assistant surgeon | $33.88 | $44.67 | $61.66 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $29.51 Median $38.90 Typical High $52.48 | Professional | AS · PA/NP assist | $29.51 | $38.90 | $52.48 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $933.25 Typical High $6,760.83 | Facility | None | $602.56 | $933.25 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $3,311.31 | Professional | None | $537.03 | $691.83 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $758.58 Median $954.99 Typical High $2,290.87 | Facility | None | $758.58 | $954.99 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $467.74 | Professional | None | $288.40 | $389.05 | $467.74 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $6,025.60 Typical High $9,120.11 | Facility | None | $1,096.48 | $6,025.60 | $9,120.11 |
United Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $501.19 | Professional | None | $208.93 | $323.59 | $501.19 |
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 $263.03 Median $281.84 Typical High $309.03 | Professional | 52 · Reduced service | $263.03 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $123.03 | Professional | 53 · Discontinued | $104.71 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $61.66 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $61.66 |
Where Indiana sits
The same service costs 10.0 times more in Alaska than in Kentucky. 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· 48th of 51
$347
AK $2,455KY $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.