How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,175 to $19,498Professionalmedian $891 · 10th to 90th $692 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 $831.76 Median $3,548.13 Typical High $14,125.38 | Facility | None | $831.76 | $3,548.13 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $1,023.29 | Professional | None | $794.33 | $831.76 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $10,964.78 Typical High $22,908.68 | Facility | None | $1,380.38 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,230.27 | Professional | None | $691.83 | $891.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,348.96 Typical High $1,905.46 | Professional | 50 · Both sides | $1,047.13 | $1,348.96 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $562.34 Typical High $794.33 | Professional | 62 · Two surgeons | $436.52 | $562.34 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $144.54 Typical High $213.80 | Professional | 80 · Assistant surgeon | $112.20 | $144.54 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $125.89 Typical High $177.83 | Professional | AS · PA/NP assist | $97.72 | $125.89 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $6,025.60 | Facility | None | $831.76 | $831.76 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,890.45 Typical High $6,606.93 | Facility | None | $776.25 | $3,890.45 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,479.11 | Professional | None | $776.25 | $1,000.00 | $1,479.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $6,165.95 Typical High $8,511.38 | Facility | None | $2,089.30 | $6,165.95 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,548.82 | Professional | None | $831.76 | $1,071.52 | $1,548.82 |
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 $707.95 Median $891.25 Typical High $1,380.38 | Professional | None | $707.95 | $891.25 | $1,380.38 |
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 $398.11 Median $407.38 Typical High $467.74 | Professional | 52 · Reduced service | $398.11 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $165.96 Typical High $186.21 | Professional | 53 · Discontinued | $158.49 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $588.84 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $141.25 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $83.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $79.43 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $549.54 | $575.44 | $660.69 |
Where Indiana sits
The same service costs 7.4 times more in Oklahoma 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· 42nd of 51
$955
OK $3,890TX $525
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.