How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,259 to $19,498Professionalmedian $1,445 · 10th to 90th $1,148 to $2,188
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 $3,467.37 Typical High $5,011.87 | Facility | None | $1,258.93 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,258.93 | $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 $1,479.11 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,479.11 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $912.01 Typical High $1,230.27 | Professional | 62 · Two surgeons | $724.44 | $912.01 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $234.42 Typical High $331.13 | Professional | 80 · Assistant surgeon | $186.21 | $234.42 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $204.17 Typical High $275.42 | Professional | AS · PA/NP assist | $162.18 | $204.17 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $6,025.60 | Facility | None | $1,380.38 | $1,380.38 | $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 $1,148.15 Median $1,412.54 Typical High $7,079.46 | Professional | None | $1,148.15 | $1,412.54 | $7,079.46 |
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 $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 $1,202.26 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 $1,122.02 Median $1,348.96 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,348.96 | $2,454.71 |
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 $630.96 Typical High $691.83 | Professional | 52 · Reduced service | $575.44 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $257.04 Typical High $275.42 | Professional | 53 · Discontinued | $229.09 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $954.99 Typical High $1,047.13 | Professional | 54 · Surgery only | $851.14 | $954.99 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $125.89 Typical High $138.04 | Professional | 56 · Pre-op care only | $114.82 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $891.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $794.33 | $891.25 | $977.24 |
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· 36th of 51
$1,479
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.