How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,202 to $19,498Professionalmedian $1,413 · 10th to 90th $1,023 to $2,138
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 $1,174.90 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,174.90 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,174.90 | $1,288.25 |
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 $1,023.29 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,412.54 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $891.25 Typical High $1,174.90 | Professional | 62 · Two surgeons | $645.65 | $891.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $229.09 Typical High $309.03 | Professional | 80 · Assistant surgeon | $165.96 | $229.09 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $199.53 Typical High $263.03 | Professional | AS · PA/NP assist | $144.54 | $199.53 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $1,202.26 Median $1,445.44 Typical High $6,760.83 | Professional | None | $1,202.26 | $1,445.44 | $6,760.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,311.31 Typical High $8,511.38 | Facility | None | $954.99 | $3,311.31 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,737.80 | $2,511.89 |
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 $1,023.29 Median $1,318.26 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,318.26 | $2,238.72 |
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 $512.86 Median $575.44 Typical High $602.56 | Professional | 52 · Reduced service | $512.86 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $234.42 Typical High $239.88 | Professional | 53 · Discontinued | $208.93 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $870.96 Typical High $912.01 | Professional | 54 · Surgery only | $776.25 | $870.96 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $173.78 Typical High $181.97 | Professional | 55 · Aftercare only | $154.88 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $117.49 Typical High $120.23 | Professional | 56 · Pre-op care only | $104.71 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $812.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $724.44 | $812.83 | $851.14 |
Where Indiana sits
The same service costs 14.5 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
$1,413
AK $4,898TX $339
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.