How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,148 to $15,136Professionalmedian $1,698 · 10th to 90th $1,380 to $2,692
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 $1,380.38 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,380.38 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,584.89 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,380.38 | $1,698.24 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,071.52 Typical High $1,445.44 | Professional | 62 · Two surgeons | $870.96 | $1,071.52 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $275.42 Typical High $389.05 | Professional | 80 · Assistant surgeon | $229.09 | $275.42 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $239.88 Typical High $323.59 | Professional | AS · PA/NP assist | $190.55 | $239.88 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,265.80 Typical High $7,762.47 | Facility | None | $676.08 | $4,265.80 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $9,120.11 | Professional | None | $1,584.89 | $1,819.70 | $9,120.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $4,677.35 Typical High $9,332.54 | Facility | None | $954.99 | $4,677.35 | $9,332.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,548.82 Median $2,511.89 Typical High $3,467.37 | Professional | None | $1,548.82 | $2,511.89 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $2,884.03 | Professional | None | $1,348.96 | $1,698.24 | $2,884.03 |
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 $758.58 Median $794.33 Typical High $977.24 | Professional | 52 · Reduced service | $758.58 | $794.33 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $316.23 Typical High $389.05 | Professional | 53 · Discontinued | $302.00 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,174.90 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,122.02 | $1,174.90 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $234.42 Typical High $288.40 | Professional | 55 · Aftercare only | $223.87 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $158.49 Typical High $194.98 | Professional | 56 · Pre-op care only | $151.36 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,096.48 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,096.48 | $1,348.96 |
Where Indiana sits
The same service costs 11.2 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· 42nd of 51
$1,698
AK $7,244TX $646
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.