How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,202 to $19,498Professionalmedian $1,122 · 10th to 90th $912 to $1,778
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 $1,202.26 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,202.26 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,202.26 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $11,481.54 Typical High $23,988.33 | Facility | None | $1,479.11 | $11,481.54 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,513.56 | Professional | None | $870.96 | $1,071.52 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $676.08 Typical High $954.99 | Professional | 62 · Two surgeons | $549.54 | $676.08 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $173.78 Typical High $269.15 | Professional | 80 · Assistant surgeon | $138.04 | $173.78 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $151.36 Typical High $213.80 | Professional | AS · PA/NP assist | $120.23 | $151.36 | $213.80 |
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 $3,981.07 Typical High $6,606.93 | Facility | None | $645.65 | $3,981.07 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,288.25 | $1,905.46 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,235.94 Typical High $8,511.38 | Facility | None | $954.99 | $3,235.94 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,584.89 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,230.27 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $2,041.74 | Professional | None | $912.01 | $1,230.27 | $2,041.74 |
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 $575.44 Median $602.56 Typical High $676.08 | Professional | 52 · Reduced service | $575.44 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $275.42 | Professional | 53 · Discontinued | $234.42 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $891.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $870.96 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $177.83 Typical High $204.17 | Professional | 55 · Aftercare only | $173.78 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $138.04 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $831.76 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $812.83 | $831.76 | $954.99 |
Where Indiana sits
The same service costs 6.5 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· 43rd of 51
$1,230
AK $4,898TX $759
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.