How much rates vary
Facilitymedian $5,248 · 10th to 90th $692 to $25,119Professionalmedian $2,818 · 10th to 90th $1,820 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 $2,344.23 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,344.23 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $2,630.27 | Professional | None | $2,137.96 | $2,344.23 | $2,630.27 |
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 $1,778.28 Median $3,162.28 Typical High $4,265.80 | Professional | None | $1,778.28 | $3,162.28 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,995.26 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,122.02 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $501.19 Typical High $758.58 | Professional | 80 · Assistant surgeon | $281.84 | $501.19 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $436.52 Typical High $588.84 | Professional | AS · PA/NP assist | $245.47 | $436.52 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,454.71 Typical High $4,570.88 | Facility | None | $575.44 | $2,454.71 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,754.23 Typical High $4,265.80 | Professional | None | $1,995.26 | $2,754.23 | $4,265.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,691.53 Typical High $5,370.32 | Facility | None | $912.01 | $2,691.53 | $5,370.32 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $3,467.37 | Professional | None | $2,187.76 | $2,570.40 | $3,467.37 |
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 $1,995.26 Median $2,884.03 Typical High $4,073.80 | Professional | None | $1,995.26 | $2,884.03 | $4,073.80 |
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 $1,071.52 Median $1,174.90 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,071.52 | $1,174.90 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $467.74 Typical High $524.81 | Professional | 53 · Discontinued | $426.58 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,778.28 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,584.89 | $1,778.28 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $354.81 Typical High $389.05 | Professional | 55 · Aftercare only | $316.23 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $234.42 Typical High $263.03 | Professional | 56 · Pre-op care only | $213.80 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,659.59 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,659.59 | $1,819.70 |
Where Indiana sits
The same service costs 5.4 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· 16th of 51
$3,162
AK $8,318TX $1,549
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.