How much rates vary
Facilitymedian $7,079 · 10th to 90th $676 to $43,652Professionalmedian $2,884 · 10th to 90th $1,820 to $4,467
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 $2,238.72 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,238.72 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,454.71 | Professional | None | $1,995.26 | $2,238.72 | $2,454.71 |
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 $1,698.24 Median $3,388.44 Typical High $4,570.88 | Professional | None | $1,698.24 | $3,388.44 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $2,137.96 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,071.52 | $2,137.96 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $537.03 Typical High $794.33 | Professional | 80 · Assistant surgeon | $269.15 | $537.03 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $467.74 Typical High $630.96 | Professional | AS · PA/NP assist | $234.42 | $467.74 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $1,949.84 Median $2,818.38 Typical High $4,570.88 | Professional | None | $1,949.84 | $2,818.38 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,511.89 Typical High $5,128.61 | Facility | None | $912.01 | $2,511.89 | $5,128.61 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $3,311.31 | Professional | None | $2,089.30 | $2,454.71 | $3,311.31 |
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 $1,905.46 Median $2,691.53 Typical High $3,890.45 | Professional | None | $1,905.46 | $2,691.53 | $3,890.45 |
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 $1,000.00 Median $1,122.02 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,000.00 | $1,122.02 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $446.68 Typical High $501.19 | Professional | 53 · Discontinued | $407.38 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,659.59 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,513.56 | $1,659.59 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $331.13 Typical High $371.54 | Professional | 55 · Aftercare only | $302.00 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $223.87 Typical High $245.47 | Professional | 56 · Pre-op care only | $199.53 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,548.82 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,548.82 | $1,737.80 |
Where Indiana sits
The same service costs 5.8 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· 15th of 51
$3,090
AK $7,943TX $1,380
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.