How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,000 to $15,136Professionalmedian $1,479 · 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 $1,096.48 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,096.48 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,096.48 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,230.27 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,621.81 Typical High $1,949.84 | Professional | None | $977.24 | $1,621.81 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $2,454.71 Typical High $3,019.95 | Professional | 50 · Both sides | $1,479.11 | $2,454.71 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $1,023.29 Typical High $1,258.93 | Professional | 62 · Two surgeons | $616.60 | $1,023.29 | $1,258.93 |
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 $229.09 Typical High $281.84 | Professional | AS · PA/NP assist | $138.04 | $229.09 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,025.60 Typical High $10,232.93 | Facility | None | $645.65 | $6,025.60 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $8,128.31 | Professional | None | $1,202.26 | $1,513.56 | $8,128.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $11,481.54 | Facility | None | $912.01 | $2,454.71 | $11,481.54 |
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 $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $2,137.96 | Professional | None | $954.99 | $1,288.25 | $2,137.96 |
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 $549.54 Typical High $616.60 | Professional | 52 · Reduced service | $501.19 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $218.78 Typical High $245.47 | Professional | 53 · Discontinued | $204.17 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $912.01 | Professional | 54 · Surgery only | $758.58 | $831.76 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $181.97 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $123.03 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $851.14 |
Where Indiana sits
The same service costs 8.7 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· 30th of 51
$1,585
AK $4,786TX $550
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.