How much rates vary
Facilitymedian $10,471 · 10th to 90th $851 to $25,704Professionalmedian $1,288 · 10th to 90th $891 to $1,820
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 $933.25 Median $3,467.37 Typical High $5,011.87 | Facility | None | $933.25 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,174.90 | Professional | None | $933.25 | $933.25 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,398.83 Median $18,197.01 Typical High $27,542.29 | Facility | None | $2,398.83 | $18,197.01 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,380.38 Typical High $1,819.70 | Professional | None | $870.96 | $1,380.38 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $870.96 Typical High $1,174.90 | Professional | 62 · Two surgeons | $549.54 | $870.96 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $218.78 Typical High $309.03 | Professional | 80 · Assistant surgeon | $138.04 | $218.78 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $190.55 Typical High $257.04 | Professional | AS · PA/NP assist | $120.23 | $190.55 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,949.84 | Professional | None | $954.99 | $1,288.25 | $1,949.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,137.96 Typical High $2,630.27 | Facility | None | $912.01 | $2,137.96 | $2,630.27 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,258.93 | $1,905.46 |
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 $912.01 Median $1,148.15 Typical High $1,698.24 | Professional | None | $912.01 | $1,148.15 | $1,698.24 |
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 $467.74 Median $467.74 Typical High $588.84 | Professional | 52 · Reduced service | $467.74 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $234.42 | Professional | 53 · Discontinued | $186.21 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $870.96 | Professional | 54 · Surgery only | $707.95 | $707.95 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $173.78 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $117.49 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $812.83 |
Where Indiana sits
The same service costs 6.8 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· 23rd of 51
$1,380
AK $3,981TX $589
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.