How much rates vary
Facilitymedian $7,079 · 10th to 90th $676 to $43,652Professionalmedian $2,399 · 10th to 90th $1,549 to $3,548
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 $1,949.84 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,949.84 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,778.28 | $1,949.84 | $2,187.76 |
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 $1,479.11 Median $2,630.27 Typical High $3,548.13 | Professional | None | $1,479.11 | $2,630.27 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,659.59 Typical High $2,187.76 | Professional | 62 · Two surgeons | $933.25 | $1,659.59 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $416.87 Typical High $630.96 | Professional | 80 · Assistant surgeon | $234.42 | $416.87 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $363.08 Typical High $489.78 | Professional | AS · PA/NP assist | $208.93 | $363.08 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $1,737.80 Median $2,344.23 Typical High $3,715.35 | Professional | None | $1,737.80 | $2,344.23 | $3,715.35 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $4,466.84 | Facility | None | $912.01 | $2,290.87 | $4,466.84 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,819.70 | $2,137.96 | $2,884.03 |
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 $1,659.59 Median $2,398.83 Typical High $3,388.44 | Professional | None | $1,659.59 | $2,398.83 | $3,388.44 |
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 $891.25 Median $977.24 Typical High $1,096.48 | Professional | 52 · Reduced service | $891.25 | $977.24 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $389.05 Typical High $436.52 | Professional | 53 · Discontinued | $354.81 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,479.11 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,318.26 | $1,479.11 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $295.12 Typical High $323.59 | Professional | 55 · Aftercare only | $263.03 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $194.98 Typical High $218.78 | Professional | 56 · Pre-op care only | $177.83 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,380.38 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,380.38 | $1,513.56 |
Where Indiana sits
The same service costs 5.5 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· 19th of 51
$2,630
AK $6,918TX $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.