How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,096 to $19,498Professionalmedian $1,288 · 10th to 90th $912 to $1,905
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 $954.99 Median $5,011.87 Typical High $11,220.18 | Facility | None | $954.99 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,096.48 | Professional | None | $851.14 | $954.99 | $1,096.48 |
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 $851.14 Median $1,348.96 Typical High $1,698.24 | Professional | None | $851.14 | $1,348.96 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $851.14 Typical High $1,122.02 | Professional | 62 · Two surgeons | $537.03 | $851.14 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $213.80 Typical High $288.40 | Professional | 80 · Assistant surgeon | $134.90 | $213.80 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $190.55 Typical High $239.88 | Professional | AS · PA/NP assist | $120.23 | $190.55 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $6,025.60 | Facility | None | $1,023.29 | $1,023.29 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,981.07 Typical High $6,606.93 | Facility | None | $630.96 | $3,981.07 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $6,309.57 | Professional | None | $1,047.13 | $1,288.25 | $6,309.57 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $5,495.41 Typical High $8,511.38 | Facility | None | $2,089.30 | $5,495.41 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,445.44 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $2,041.74 | Professional | None | $912.01 | $1,174.90 | $2,041.74 |
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 $426.58 Median $478.63 Typical High $524.81 | Professional | 52 · Reduced service | $426.58 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $190.55 Typical High $213.80 | Professional | 53 · Discontinued | $169.82 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $645.65 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $158.49 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $95.50 Typical High $104.71 | Professional | 56 · Pre-op care only | $85.11 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $676.08 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $602.56 | $676.08 | $741.31 |
Where Indiana sits
The same service costs 7.9 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· 32nd of 51
$1,349
AK $4,074TX $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.