How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,259 to $19,498Professionalmedian $1,585 · 10th to 90th $1,148 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 $1,288.25 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,288.25 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,288.25 | $1,412.54 |
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 $1,148.15 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,621.81 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,023.29 Typical High $1,348.96 | Professional | 62 · Two surgeons | $724.44 | $1,023.29 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $263.03 Typical High $363.08 | Professional | 80 · Assistant surgeon | $186.21 | $263.03 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $229.09 Typical High $302.00 | Professional | AS · PA/NP assist | $162.18 | $229.09 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,011.87 Typical High $8,317.64 | Facility | None | $645.65 | $5,011.87 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $7,762.47 | Professional | None | $1,288.25 | $1,584.89 | $7,762.47 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,715.35 Typical High $9,772.37 | Facility | None | $912.01 | $3,715.35 | $9,772.37 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,905.46 | $2,754.23 |
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 $1,122.02 Median $1,445.44 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,445.44 | $2,511.89 |
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 $575.44 Median $645.65 Typical High $676.08 | Professional | 52 · Reduced service | $575.44 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $257.04 Typical High $269.15 | Professional | 53 · Discontinued | $229.09 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $1,000.00 | Professional | 54 · Surgery only | $870.96 | $977.24 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $194.98 Typical High $199.53 | Professional | 55 · Aftercare only | $173.78 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $128.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $114.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $912.01 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $812.83 | $912.01 | $933.25 |
Where Indiana sits
The same service costs 17.0 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· 34th of 51
$1,622
AK $5,495TX $324
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.