How much rates vary
Facilitymedian $5,754 · 10th to 90th $676 to $25,119Professionalmedian $1,820 · 10th to 90th $1,148 to $2,630
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 $1,479.11 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,479.11 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,479.11 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $12,022.64 Typical High $28,840.32 | Facility | None | $1,621.81 | $12,022.64 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,949.84 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,230.27 Typical High $1,659.59 | Professional | 62 · Two surgeons | $724.44 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $309.03 Typical High $467.74 | Professional | 80 · Assistant surgeon | $181.97 | $309.03 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $275.42 Typical High $371.54 | Professional | AS · PA/NP assist | $158.49 | $275.42 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $1,318.26 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,737.80 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,467.37 | Facility | None | $912.01 | $2,290.87 | $3,467.37 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,659.59 | $2,187.76 |
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 $1,230.27 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,737.80 | $2,511.89 |
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 $660.69 Median $741.31 Typical High $831.76 | Professional | 52 · Reduced service | $660.69 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $295.12 Typical High $331.13 | Professional | 53 · Discontinued | $263.03 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $245.47 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $147.91 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,148.15 |
Where Indiana sits
The same service costs 5.0 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· 20th of 51
$1,950
AK $5,248TX $1,047
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.