How much rates vary
Facilitymedian $7,079 · 10th to 90th $676 to $43,652Professionalmedian $2,692 · 10th to 90th $1,778 to $4,169
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 $2,187.76 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,187.76 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,187.76 Typical High $2,398.83 | Professional | None | $1,949.84 | $2,187.76 | $2,398.83 |
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 $1,621.81 Median $3,162.28 Typical High $4,265.80 | Professional | None | $1,621.81 | $3,162.28 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,995.26 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,023.29 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $512.86 Typical High $741.31 | Professional | 80 · Assistant surgeon | $263.03 | $512.86 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $446.68 Typical High $602.56 | Professional | AS · PA/NP assist | $229.09 | $446.68 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
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 $1,905.46 Median $2,754.23 Typical High $4,365.16 | Professional | None | $1,905.46 | $2,754.23 | $4,365.16 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $5,011.87 | Facility | None | $912.01 | $2,454.71 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $3,162.28 | Professional | None | $2,041.74 | $2,398.83 | $3,162.28 |
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 $1,862.09 Median $2,630.27 Typical High $3,715.35 | Professional | None | $1,862.09 | $2,630.27 | $3,715.35 |
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 $977.24 Median $1,071.52 Typical High $1,202.26 | Professional | 52 · Reduced service | $977.24 | $1,071.52 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $436.52 Typical High $478.63 | Professional | 53 · Discontinued | $389.05 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,621.81 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,479.11 | $1,621.81 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $323.59 Typical High $363.08 | Professional | 55 · Aftercare only | $295.12 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $218.78 Typical High $239.88 | Professional | 56 · Pre-op care only | $194.98 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,513.56 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,513.56 | $1,698.24 |
Where Indiana sits
The same service costs 6.2 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· 17th of 51
$3,020
AK $7,762TX $1,259
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.