How much rates vary
Facilitymedian $6,761 · 10th to 90th $692 to $41,687Professionalmedian $2,570 · 10th to 90th $1,622 to $3,802
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 $2,137.96 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,137.96 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,344.23 | Professional | None | $1,905.46 | $2,137.96 | $2,344.23 |
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 $2,884.03 Typical High $3,890.45 | Professional | None | $1,621.81 | $2,884.03 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,819.70 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,023.29 | $1,819.70 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $457.09 Typical High $691.83 | Professional | 80 · Assistant surgeon | $257.04 | $457.09 | $691.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $407.38 Typical High $537.03 | Professional | AS · PA/NP assist | $223.87 | $407.38 | $537.03 |
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 $562.34 Median $2,089.30 Typical High $4,265.80 | Facility | None | $562.34 | $2,089.30 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $3,890.45 | Professional | None | $1,819.70 | $2,454.71 | $3,890.45 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,398.83 Typical High $4,897.79 | Facility | None | $912.01 | $2,398.83 | $4,897.79 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,995.26 | $2,344.23 | $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 $1,778.28 Median $2,570.40 Typical High $3,630.78 | Professional | None | $1,778.28 | $2,570.40 | $3,630.78 |
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 $954.99 Median $1,071.52 Typical High $1,174.90 | Professional | 52 · Reduced service | $954.99 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $426.58 Typical High $478.63 | Professional | 53 · Discontinued | $389.05 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,584.89 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,445.44 | $1,584.89 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $316.23 Typical High $354.81 | Professional | 55 · Aftercare only | $288.40 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | 56 · Pre-op care only | $190.55 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,479.11 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,479.11 | $1,659.59 |
Where Indiana sits
The same service costs 5.9 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· 18th of 51
$2,884
AK $7,586TX $1,288
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.