How much rates vary
Facilitymedian $9,120 · 10th to 90th $891 to $23,442Professionalmedian $1,148 · 10th to 90th $813 to $1,698
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 $977.24 Median $3,467.37 Typical High $5,011.87 | Facility | None | $977.24 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,202.26 | Professional | None | $977.24 | $977.24 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $15,488.17 Typical High $25,703.96 | Facility | None | $1,862.09 | $15,488.17 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,513.56 | Professional | None | $812.83 | $1,148.15 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,737.80 Typical High $2,290.87 | Professional | 50 · Both sides | $1,258.93 | $1,737.80 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $724.44 Typical High $977.24 | Professional | 62 · Two surgeons | $512.86 | $724.44 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $186.21 Typical High $263.03 | Professional | 80 · Assistant surgeon | $144.54 | $186.21 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $162.18 Typical High $213.80 | Professional | AS · PA/NP assist | $117.49 | $162.18 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,288.25 Typical High $2,691.53 | Facility | None | $575.44 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $5,248.07 | Professional | None | $758.58 | $1,202.26 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $2,884.03 | Facility | None | $912.01 | $2,290.87 | $2,884.03 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $2,089.30 | Professional | None | $977.24 | $1,479.11 | $2,089.30 |
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 $794.33 Median $1,000.00 Typical High $1,778.28 | Professional | None | $794.33 | $1,000.00 | $1,778.28 |
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 $478.63 Median $489.78 Typical High $602.56 | Professional | 52 · Reduced service | $478.63 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $239.88 | Professional | 53 · Discontinued | $194.98 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $891.25 | Professional | 54 · Surgery only | $724.44 | $724.44 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $177.83 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $831.76 |
Where Indiana sits
The same service costs 21.9 times more in Alaska than in Texas. 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· 36th of 51
$1,148
AK $4,467TX $204
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.