How much rates vary
Facilitymedian $5,754 · 10th to 90th $676 to $25,119Professionalmedian $1,862 · 10th to 90th $1,202 to $2,570
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 $1,513.56 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,513.56 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,513.56 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $12,022.64 Typical High $28,840.32 | Facility | None | $1,621.81 | $12,022.64 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,862.09 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $1,174.90 Typical High $1,584.89 | Professional | 62 · Two surgeons | $741.31 | $1,174.90 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $295.12 Typical High $446.68 | Professional | 80 · Assistant surgeon | $190.55 | $295.12 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $257.04 Typical High $346.74 | Professional | AS · PA/NP assist | $165.96 | $257.04 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $1,348.96 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,348.96 | $1,862.09 | $2,884.03 |
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 $1,737.80 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,737.80 | $2,290.87 |
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 $1,819.70 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,819.70 | $2,570.40 |
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 $691.83 Median $758.58 Typical High $851.14 | Professional | 52 · Reduced service | $691.83 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $338.84 | Professional | 53 · Discontinued | $275.42 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,148.15 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,023.29 | $1,148.15 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $229.09 Typical High $257.04 | Professional | 55 · Aftercare only | $204.17 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $169.82 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,071.52 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $954.99 | $1,071.52 | $1,202.26 |
Where Indiana sits
The same service costs 5.4 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· 32nd of 51
$1,862
AK $5,370TX $1,000
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.