How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,288 to $14,454Professionalmedian $1,288 · 10th to 90th $1,047 to $2,138
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 $1,288.25 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,288.25 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,288.25 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,445.44 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,905.46 Typical High $2,570.40 | Professional | 50 · Both sides | $1,621.81 | $1,905.46 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $204.17 Typical High $316.23 | Professional | 80 · Assistant surgeon | $173.78 | $204.17 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $177.83 Typical High $239.88 | Professional | AS · PA/NP assist | $151.36 | $177.83 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $3,311.31 | Facility | None | $1,348.96 | $1,348.96 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,570.40 Typical High $3,801.89 | Facility | None | $891.25 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,412.54 Typical High $2,398.83 | Professional | None | $870.96 | $1,412.54 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,905.46 Median $3,467.37 Typical High $5,495.41 | Facility | None | $1,905.46 | $3,467.37 | $5,495.41 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,513.56 | $2,041.74 | $2,511.89 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,412.54 | $2,344.23 |
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 $645.65 Median $645.65 Typical High $776.25 | Professional | 52 · Reduced service | $645.65 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,071.52 |
Where Indiana sits
The same service costs 7.4 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· 39th of 51
$1,413
AK $5,623UT $759
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.