How much rates vary
Facilitymedian $2,818 · 10th to 90th $661 to $8,318Professionalmedian $490 · 10th to 90th $398 to $759
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 $436.52 Median $5,011.87 Typical High $7,244.36 | Facility | None | $436.52 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $478.63 | Professional | None | $398.11 | $436.52 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $645.65 | Professional | None | $398.11 | $489.78 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $741.31 Typical High $1,000.00 | Professional | 50 · Both sides | $602.56 | $741.31 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $79.43 Typical High $112.20 | Professional | 80 · Assistant surgeon | $64.57 | $79.43 | $112.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $69.18 Typical High $93.33 | Professional | AS · PA/NP assist | $56.23 | $69.18 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $1,905.46 | Facility | None | $467.74 | $467.74 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,148.15 Typical High $2,187.76 | Facility | None | $501.19 | $1,148.15 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $2,290.87 | Professional | None | $416.87 | $549.54 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $3,090.30 | Facility | None | $1,071.52 | $2,089.30 | $3,090.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $891.25 | Professional | None | $457.09 | $645.65 | $891.25 |
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 $478.63 Typical High $812.83 | Professional | None | $389.05 | $478.63 | $812.83 |
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 $199.53 Median $218.78 Typical High $223.87 | Professional | 52 · Reduced service | $199.53 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $89.13 | Professional | 53 · Discontinued | $79.43 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $338.84 | Professional | 54 · Surgery only | $302.00 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $44.67 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $281.84 | $302.00 | $316.23 |
Where Indiana sits
The same service costs 5.8 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· 40th of 51
$490
AK $1,862UT $324
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.