How much rates vary
Facilitymedian $5,370 · 10th to 90th $692 to $25,704Professionalmedian $1,202 · 10th to 90th $1,000 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 $1,071.52 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,071.52 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,071.52 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $10,715.19 Typical High $28,840.32 | Facility | None | $1,778.28 | $10,715.19 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,698.24 | Professional | None | $954.99 | $1,202.26 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $758.58 Typical High $1,071.52 | Professional | 62 · Two surgeons | $602.56 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $194.98 Typical High $288.40 | Professional | 80 · Assistant surgeon | $154.88 | $194.98 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $169.82 Typical High $239.88 | Professional | AS · PA/NP assist | $134.90 | $169.82 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,318.26 Typical High $2,691.53 | Facility | None | $562.34 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,348.96 | $1,905.46 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,019.95 | Facility | None | $912.01 | $2,290.87 | $3,019.95 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,479.11 | $2,187.76 |
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 $1,000.00 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,318.26 | $1,949.84 |
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 $537.03 Median $537.03 Typical High $676.08 | Professional | 52 · Reduced service | $537.03 | $537.03 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $269.15 | Professional | 53 · Discontinued | $213.80 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $1,000.00 | Professional | 54 · Surgery only | $812.83 | $812.83 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $199.53 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $134.90 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $933.25 |
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· 37th of 51
$1,230
AK $4,571TX $676
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.