How much rates vary
Facilitymedian $6,918 · 10th to 90th $933 to $28,840Professionalmedian $933 · 10th to 90th $741 to $1,413
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 $812.83 Median $5,011.87 Typical High $11,220.18 | Facility | None | $812.83 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $912.01 | Professional | None | $707.95 | $812.83 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $776.25 Median $933.25 Typical High $1,230.27 | Professional | None | $776.25 | $933.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $588.84 Typical High $794.33 | Professional | 62 · Two surgeons | $489.78 | $588.84 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $147.91 Typical High $213.80 | Professional | 80 · Assistant surgeon | $123.03 | $147.91 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $131.83 Typical High $177.83 | Professional | AS · PA/NP assist | $107.15 | $131.83 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $10,000.00 | Facility | None | $851.14 | $851.14 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,754.40 Typical High $10,715.19 | Facility | None | $645.65 | $5,754.40 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $5,754.40 | Professional | None | $851.14 | $1,071.52 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $7,585.78 Typical High $12,589.25 | Facility | None | $912.01 | $7,585.78 | $12,589.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $1,737.80 | Professional | None | $758.58 | $1,230.27 | $1,737.80 |
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 $660.69 Median $870.96 Typical High $1,479.11 | Professional | None | $660.69 | $870.96 | $1,479.11 |
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 $354.81 Median $407.38 Typical High $436.52 | Professional | 52 · Reduced service | $354.81 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $162.18 Typical High $173.78 | Professional | 53 · Discontinued | $144.54 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $602.56 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $120.23 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $81.28 Typical High $87.10 | Professional | 56 · Pre-op care only | $70.79 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $616.60 |
Where Indiana sits
The same service costs 7.6 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· 38th of 51
$933
AK $3,548TX $468
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.