How much rates vary
Facilitymedian $2,951 · 10th to 90th $708 to $8,710Professionalmedian $2,951 · 10th to 90th $2,188 to $4,365
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 $1,380.38 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,380.38 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,691.53 | Professional | None | $2,238.72 | $2,238.72 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $3,311.31 Typical High $4,365.16 | Professional | None | $2,187.76 | $3,311.31 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $2,089.30 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,380.38 | $2,089.30 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $524.81 Typical High $794.33 | Professional | 80 · Assistant surgeon | $346.74 | $524.81 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $467.74 Typical High $616.60 | Professional | AS · PA/NP assist | $302.00 | $467.74 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,754.23 | Facility | None | $2,041.74 | $2,041.74 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,737.80 Typical High $3,162.28 | Facility | None | $776.25 | $1,737.80 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,884.03 Typical High $4,365.16 | Professional | None | $1,995.26 | $2,884.03 | $4,365.16 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,023.29 Median $2,398.83 Typical High $6,606.93 | Facility | None | $1,023.29 | $2,398.83 | $6,606.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,570.40 Median $3,388.44 Typical High $4,677.35 | Professional | None | $2,570.40 | $3,388.44 | $4,677.35 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,754.23 Typical High $4,265.80 | Professional | None | $2,137.96 | $2,754.23 | $4,265.80 |
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 $1,122.02 Median $1,122.02 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $549.54 | Professional | 53 · Discontinued | $446.68 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $407.38 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $269.15 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,905.46 |
Where Indiana sits
The same service costs 15.8 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· 26th of 51
$2,951
AK $8,128TX $513
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.