How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,175 to $14,125Professionalmedian $676 · 10th to 90th $525 to $1,047
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 $602.56 Median $5,011.87 Typical High $14,125.38 | Facility | None | $602.56 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $812.83 | Professional | None | $602.56 | $602.56 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,288.25 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $912.01 | Professional | None | $524.81 | $676.08 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,023.29 Typical High $1,380.38 | Professional | 50 · Both sides | $776.25 | $1,023.29 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $426.58 Typical High $575.44 | Professional | 62 · Two surgeons | $331.13 | $426.58 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $3,311.31 | Facility | None | $645.65 | $645.65 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,570.40 Typical High $3,715.35 | Facility | None | $776.25 | $2,570.40 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $1,047.13 | Professional | None | $457.09 | $645.65 | $1,047.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,412.54 Median $2,951.21 Typical High $5,495.41 | Facility | None | $1,412.54 | $2,951.21 | $5,495.41 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,174.90 | Professional | None | $707.95 | $933.25 | $1,174.90 |
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 $549.54 Median $691.83 Typical High $1,230.27 | Professional | None | $549.54 | $691.83 | $1,230.27 |
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 $302.00 Median $302.00 Typical High $354.81 | Professional | 52 · Reduced service | $302.00 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $141.25 | Professional | 53 · Discontinued | $120.23 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $537.03 | Professional | 54 · Surgery only | $446.68 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $107.15 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $70.79 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $501.19 |
Where Indiana sits
The same service costs 8.5 times more in Wyoming 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
$692
WY $3,020UT $355
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.