How much rates vary
Facilitymedian $4,786 · 10th to 90th $692 to $15,136Professionalmedian $1,047 · 10th to 90th $708 to $1,413
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 $870.96 Median $3,467.37 Typical High $5,011.87 | Facility | None | $870.96 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,047.13 | Professional | None | $794.33 | $870.96 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,148.15 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $1,412.54 | Professional | None | $707.95 | $1,047.13 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $660.69 Typical High $891.25 | Professional | 62 · Two surgeons | $446.68 | $660.69 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $165.96 Typical High $251.19 | Professional | 80 · Assistant surgeon | $112.20 | $165.96 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $144.54 Typical High $199.53 | Professional | AS · PA/NP assist | $100.00 | $144.54 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,230.27 Typical High $2,691.53 | Facility | None | $562.34 | $1,230.27 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,584.89 | Professional | None | $776.25 | $1,047.13 | $1,584.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,041.74 Typical High $2,238.72 | Facility | None | $912.01 | $2,041.74 | $2,238.72 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,380.38 | Professional | None | $831.76 | $1,000.00 | $1,380.38 |
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 $758.58 Median $1,071.52 Typical High $1,479.11 | Professional | None | $758.58 | $1,071.52 | $1,479.11 |
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 $398.11 Median $436.52 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $177.83 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $588.84 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $549.54 | $616.60 | $691.83 |
Where Indiana sits
The same service costs 4.6 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· 34th of 51
$1,047
AK $3,162TX $692
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.