How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,380 to $19,498Professionalmedian $1,288 · 10th to 90th $1,096 to $1,995
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 $1,258.93 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,258.93 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,258.93 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $11,220.18 Typical High $22,908.68 | Facility | None | $1,513.56 | $11,220.18 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,288.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $812.83 Typical High $1,148.15 | Professional | 62 · Two surgeons | $645.65 | $812.83 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $208.93 Typical High $309.03 | Professional | 80 · Assistant surgeon | $165.96 | $208.93 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $181.97 Typical High $257.04 | Professional | AS · PA/NP assist | $144.54 | $181.97 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $6,025.60 | Facility | None | $1,288.25 | $1,288.25 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $6,606.93 | Facility | None | $891.25 | $3,890.45 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,513.56 | $2,344.23 |
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 $1,318.26 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,659.59 | $2,398.83 |
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 $1,096.48 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,412.54 | $2,187.76 |
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 $616.60 Median $630.96 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $251.19 Typical High $288.40 | Professional | 53 · Discontinued | $245.47 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $1,096.48 | Professional | 54 · Surgery only | $912.01 | $954.99 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $218.78 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $125.89 Typical High $144.54 | Professional | 56 · Pre-op care only | $123.03 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $1,023.29 |
Where Indiana sits
The same service costs 6.6 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· 42nd of 51
$1,445
AK $5,248TX $794
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.