How much rates vary
Facilitymedian $4,169 · 10th to 90th $933 to $14,125Professionalmedian $977 · 10th to 90th $724 to $1,479
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 $794.33 Median $5,011.87 Typical High $11,220.18 | Facility | None | $794.33 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $891.25 | Professional | None | $724.44 | $794.33 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,096.48 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,380.38 | Professional | None | $724.44 | $1,096.48 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,621.81 Typical High $2,137.96 | Professional | 50 · Both sides | $1,096.48 | $1,621.81 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $691.83 Typical High $912.01 | Professional | 62 · Two surgeons | $457.09 | $691.83 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $173.78 Typical High $234.42 | Professional | 80 · Assistant surgeon | $114.82 | $173.78 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $151.36 Typical High $199.53 | Professional | AS · PA/NP assist | $102.33 | $151.36 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $3,235.94 | Facility | None | $870.96 | $870.96 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,511.89 Typical High $4,365.16 | Facility | None | $645.65 | $2,511.89 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $5,128.61 | Professional | None | $831.76 | $977.24 | $5,128.61 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $3,388.44 Typical High $5,248.07 | Facility | None | $2,089.30 | $3,388.44 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,659.59 | Professional | None | $870.96 | $1,202.26 | $1,659.59 |
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 $691.83 Median $912.01 Typical High $1,513.56 | Professional | None | $691.83 | $912.01 | $1,513.56 |
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 $363.08 Median $398.11 Typical High $436.52 | Professional | 52 · Reduced service | $363.08 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $173.78 | Professional | 53 · Discontinued | $144.54 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $549.54 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $109.65 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $79.43 Typical High $87.10 | Professional | 56 · Pre-op care only | $72.44 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $549.54 | $616.60 |
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· 31st of 51
$1,096
AK $3,467TX $437
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.