How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,259 to $19,498Professionalmedian $1,413 · 10th to 90th $1,047 to $2,089
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 $1,071.52 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,174.90 | $1,318.26 |
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 $1,047.13 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,479.11 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,238.72 Typical High $2,951.21 | Professional | 50 · Both sides | $1,584.89 | $2,238.72 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $933.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $660.69 | $933.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $234.42 Typical High $316.23 | Professional | 80 · Assistant surgeon | $169.82 | $234.42 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $208.93 Typical High $275.42 | Professional | AS · PA/NP assist | $147.91 | $208.93 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,073.80 Typical High $8,128.31 | Facility | None | $691.83 | $4,073.80 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $7,585.78 | Professional | None | $1,230.27 | $1,445.44 | $7,585.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $9,772.37 | Facility | None | $912.01 | $3,388.44 | $9,772.37 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,778.28 | $2,511.89 |
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 $1,047.13 Median $1,318.26 Typical High $2,238.72 | Professional | None | $1,047.13 | $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 $537.03 Median $588.84 Typical High $645.65 | Professional | 52 · Reduced service | $537.03 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $234.42 Typical High $257.04 | Professional | 53 · Discontinued | $213.80 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $891.25 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $891.25 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $177.83 Typical High $194.98 | Professional | 55 · Aftercare only | $162.18 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $117.49 Typical High $128.82 | Professional | 56 · Pre-op care only | $107.15 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $831.76 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $831.76 | $912.01 |
Where Indiana sits
The same service costs 17.8 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
$1,479
AK $5,129TX $288
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.