How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,023 to $28,840Professionalmedian $871 · 10th to 90th $631 to $1,318
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 $691.83 Median $5,011.87 Typical High $11,220.18 | Facility | None | $691.83 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $776.25 | Professional | None | $630.96 | $691.83 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,122.02 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $1,202.26 | Professional | None | $630.96 | $954.99 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,445.44 Typical High $1,905.46 | Professional | 50 · Both sides | $954.99 | $1,445.44 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $602.56 Typical High $794.33 | Professional | 62 · Two surgeons | $398.11 | $602.56 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $154.88 Typical High $204.17 | Professional | 80 · Assistant surgeon | $102.33 | $154.88 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $134.90 Typical High $177.83 | Professional | AS · PA/NP assist | $89.13 | $134.90 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $7,244.36 | Facility | None | $758.58 | $758.58 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,786.30 Typical High $7,943.28 | Facility | None | $630.96 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $4,897.79 | Professional | None | $741.31 | $912.01 | $4,897.79 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,584.89 Median $6,606.93 Typical High $10,471.29 | Facility | None | $1,584.89 | $6,606.93 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,445.44 | Professional | None | $724.44 | $1,047.13 | $1,445.44 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,288.25 | Professional | None | $588.84 | $776.25 | $1,288.25 |
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 $316.23 Median $346.74 Typical High $380.19 | Professional | 52 · Reduced service | $316.23 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $562.34 | Professional | 54 · Surgery only | $467.74 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $114.82 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $524.81 |
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· 28th of 51
$955
AK $3,020TX $380
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.