How much rates vary
Facilitymedian $7,079 · 10th to 90th $692 to $41,687Professionalmedian $3,467 · 10th to 90th $2,754 to $5,370
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 $2,344.23 Median $3,548.13 Typical High $5,011.87 | Facility | None | $2,344.23 | $3,548.13 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $3,235.94 Median $3,548.13 Typical High $3,981.07 | Professional | None | $3,235.94 | $3,548.13 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,445.44 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $3,467.37 Typical High $5,011.87 | Professional | None | $2,754.23 | $3,467.37 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $2,187.76 Typical High $3,162.28 | Professional | 62 · Two surgeons | $1,737.80 | $2,187.76 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $562.34 Typical High $870.96 | Professional | 80 · Assistant surgeon | $436.52 | $562.34 | $870.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $489.78 Typical High $691.83 | Professional | AS · PA/NP assist | $380.19 | $489.78 | $691.83 |
CareSource Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,691.53 Typical High $6,760.83 | Facility | None | $562.34 | $2,691.53 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $3,715.35 Typical High $5,888.44 | Professional | None | $2,818.38 | $3,715.35 | $5,888.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $4,073.80 Typical High $8,317.64 | Facility | None | $912.01 | $4,073.80 | $8,317.64 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3,311.31 Median $3,981.07 Typical High $5,248.07 | Professional | None | $3,311.31 | $3,981.07 | $5,248.07 |
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 $2,951.21 Median $4,365.16 Typical High $6,025.60 | Professional | None | $2,951.21 | $4,365.16 | $6,025.60 |
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 $1,621.81 Median $1,778.28 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,621.81 | $1,778.28 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $724.44 Typical High $794.33 | Professional | 53 · Discontinued | $645.65 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,691.53 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,398.83 | $2,691.53 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $537.03 Typical High $602.56 | Professional | 55 · Aftercare only | $489.78 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $354.81 Typical High $398.11 | Professional | 56 · Pre-op care only | $323.59 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,511.89 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,511.89 | $2,818.38 |
Where Indiana sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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· 36th of 51
$3,548
AK $12,589AR $1,995
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.