How much rates vary
Facilitymedian $8,913 · 10th to 90th $1,230 to $28,840Professionalmedian $1,445 · 10th to 90th $977 to $2,239
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 $1,071.52 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,071.52 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,202.26 | Professional | None | $1,000.00 | $1,071.52 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,479.11 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,659.59 Typical High $1,995.26 | Professional | None | $977.24 | $1,659.59 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $2,511.89 Typical High $3,090.30 | Professional | 50 · Both sides | $1,479.11 | $2,511.89 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $1,047.13 Typical High $1,288.25 | Professional | 62 · Two surgeons | $616.60 | $1,047.13 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $263.03 Typical High $354.81 | Professional | 80 · Assistant surgeon | $154.88 | $263.03 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $234.42 Typical High $288.40 | Professional | AS · PA/NP assist | $138.04 | $234.42 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $9,120.11 | Facility | None | $1,202.26 | $1,202.26 | $9,120.11 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $5,888.44 Typical High $10,964.78 | Facility | None | $794.33 | $5,888.44 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $9,120.11 | Professional | None | $1,202.26 | $1,584.89 | $9,120.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $9,549.93 Typical High $13,182.57 | Facility | None | $2,089.30 | $9,549.93 | $13,182.57 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,621.81 | $2,344.23 |
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 $933.25 Median $1,288.25 Typical High $2,238.72 | Professional | None | $933.25 | $1,288.25 | $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 $501.19 Median $537.03 Typical High $602.56 | Professional | 52 · Reduced service | $501.19 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $239.88 | Professional | 53 · Discontinued | $199.53 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $891.25 | Professional | 54 · Surgery only | $741.31 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $120.23 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $831.76 |
Where Indiana sits
The same service costs 8.3 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· 26th of 51
$1,660
AK $4,786TX $575
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.