How much rates vary
Facilitymedian $9,333 · 10th to 90th $891 to $22,909Professionalmedian $1,820 · 10th to 90th $1,259 to $2,754
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 $1,412.54 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,412.54 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,412.54 | $1,659.59 |
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 $1,148.15 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,148.15 | $2,041.74 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,288.25 Typical High $1,737.80 | Professional | 62 · Two surgeons | $724.44 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $331.13 Typical High $467.74 | Professional | 80 · Assistant surgeon | $181.97 | $331.13 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $288.40 Typical High $389.05 | Professional | AS · PA/NP assist | $158.49 | $288.40 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,621.81 Typical High $2,884.03 | Facility | None | $562.34 | $1,621.81 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,778.28 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,630.78 | Facility | None | $912.01 | $2,290.87 | $3,630.78 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,862.09 | $2,511.89 |
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 $1,288.25 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,659.59 | $2,398.83 |
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 $707.95 Median $707.95 Typical High $812.83 | Professional | 52 · Reduced service | $707.95 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,071.52 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,047.13 | $1,071.52 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $213.80 Typical High $245.47 | Professional | 55 · Aftercare only | $208.93 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,000.00 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $977.24 | $1,000.00 | $1,148.15 |
Where Indiana sits
The same service costs 7.8 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· 16th of 51
$2,042
AK $5,754TX $741
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.