How much rates vary
Facilitymedian $9,120 · 10th to 90th $891 to $22,909Professionalmedian $2,630 · 10th to 90th $1,995 to $3,715
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 $2,344.23 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,344.23 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,398.83 Typical High $2,754.23 | Professional | None | $2,290.87 | $2,398.83 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $15,135.61 Typical High $24,547.09 | Facility | None | $2,041.74 | $15,135.61 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,630.27 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,630.27 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,659.59 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,230.27 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $426.58 Typical High $630.96 | Professional | 80 · Assistant surgeon | $316.23 | $426.58 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $371.54 Typical High $501.19 | Professional | AS · PA/NP assist | $275.42 | $371.54 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,691.53 Typical High $4,786.30 | Facility | None | $575.44 | $2,691.53 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $2,818.38 Typical High $3,801.89 | Professional | None | $2,238.72 | $2,818.38 | $3,801.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,951.21 Typical High $6,309.57 | Facility | None | $912.01 | $2,951.21 | $6,309.57 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,398.83 Median $3,090.30 Typical High $4,365.16 | Professional | None | $2,398.83 | $3,090.30 | $4,365.16 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,754.23 Typical High $4,168.69 | Professional | None | $2,137.96 | $2,754.23 | $4,168.69 |
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 $1,148.15 Median $1,174.90 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,148.15 | $1,174.90 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $478.63 Typical High $549.54 | Professional | 53 · Discontinued | $467.74 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,778.28 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,737.80 | $1,778.28 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $354.81 Typical High $416.87 | Professional | 55 · Aftercare only | $346.74 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $239.88 Typical High $275.42 | Professional | 56 · Pre-op care only | $229.09 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,659.59 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,659.59 | $1,905.46 |
Where Indiana sits
The same service costs 11.0 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· 37th of 51
$2,630
AK $9,772TX $891
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.