How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,259 to $19,498Professionalmedian $1,514 · 10th to 90th $1,122 to $2,291
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 $1,258.93 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,258.93 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,380.38 | Professional | None | $1,122.02 | $1,258.93 | $1,380.38 |
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 $1,122.02 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,548.82 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $954.99 Typical High $1,288.25 | Professional | 62 · Two surgeons | $707.95 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $245.47 Typical High $346.74 | Professional | 80 · Assistant surgeon | $181.97 | $245.47 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $213.80 Typical High $281.84 | Professional | AS · PA/NP assist | $158.49 | $213.80 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,981.07 Typical High $6,606.93 | Facility | None | $645.65 | $3,981.07 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $6,918.31 | Professional | None | $1,258.93 | $1,548.82 | $6,918.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,630.78 Typical High $8,511.38 | Facility | None | $912.01 | $3,630.78 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,862.09 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,230.27 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,445.44 | $2,398.83 |
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 $562.34 Median $630.96 Typical High $660.69 | Professional | 52 · Reduced service | $562.34 | $630.96 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $251.19 Typical High $263.03 | Professional | 53 · Discontinued | $223.87 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $933.25 Typical High $977.24 | Professional | 54 · Surgery only | $831.76 | $933.25 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $190.55 Typical High $194.98 | Professional | 55 · Aftercare only | $169.82 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $125.89 Typical High $131.83 | Professional | 56 · Pre-op care only | $112.20 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $870.96 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $776.25 | $870.96 | $912.01 |
Where Indiana sits
The same service costs 15.1 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· 33rd of 51
$1,549
AK $5,370TX $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.