How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,148 to $19,498Professionalmedian $851 · 10th to 90th $661 to $1,445
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 $851.14 Median $5,011.87 Typical High $11,220.18 | Facility | None | $851.14 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $954.99 | Professional | None | $776.25 | $851.14 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $11,481.54 Typical High $23,988.33 | Facility | None | $1,479.11 | $11,481.54 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,096.48 | Professional | None | $660.69 | $776.25 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $489.78 Typical High $707.95 | Professional | 62 · Two surgeons | $416.87 | $489.78 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $125.89 Typical High $194.98 | Professional | 80 · Assistant surgeon | $107.15 | $125.89 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $109.65 Typical High $154.88 | Professional | AS · PA/NP assist | $93.33 | $109.65 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $6,025.60 | Facility | None | $933.25 | $933.25 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,467.37 Typical High $6,456.54 | Facility | None | $645.65 | $3,467.37 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $5,128.61 | Professional | None | $891.25 | $1,023.29 | $5,128.61 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $6,165.95 Typical High $8,511.38 | Facility | None | $2,089.30 | $6,165.95 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $1,778.28 | Professional | None | $870.96 | $1,258.93 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,621.81 | Professional | None | $741.31 | $954.99 | $1,621.81 |
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 $389.05 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $691.83 | Professional | 54 · Surgery only | $575.44 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $128.82 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $85.11 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $645.65 |
Where Indiana sits
The same service costs 20.0 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· 40th of 51
$933
AK $3,715TX $186
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.