How much rates vary
Facilitymedian $5,129 · 10th to 90th $692 to $25,119Professionalmedian $1,622 · 10th to 90th $1,047 to $2,455
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 $1,288.25 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,288.25 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,288.25 | $1,445.44 |
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 $977.24 Median $1,862.09 Typical High $2,511.89 | Professional | None | $977.24 | $1,862.09 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $1,174.90 Typical High $1,584.89 | Professional | 62 · Two surgeons | $616.60 | $1,174.90 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $295.12 Typical High $436.52 | Professional | 80 · Assistant surgeon | $158.49 | $295.12 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $263.03 Typical High $354.81 | Professional | AS · PA/NP assist | $138.04 | $263.03 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,737.80 Typical High $2,691.53 | Facility | None | $575.44 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,548.82 | $2,454.71 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $2,951.21 | Facility | None | $912.01 | $2,290.87 | $2,951.21 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,202.26 | $1,412.54 | $1,905.46 |
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 $1,122.02 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,548.82 | $2,187.76 |
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 $575.44 Median $645.65 Typical High $724.44 | Professional | 52 · Reduced service | $575.44 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $288.40 | Professional | 53 · Discontinued | $234.42 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $954.99 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $128.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $114.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $891.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $812.83 | $891.25 | $1,000.00 |
Where Indiana sits
The same service costs 5.6 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· 17th of 51
$1,862
AK $4,571TX $813
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.