How much rates vary
Facilitymedian $7,079 · 10th to 90th $676 to $43,652Professionalmedian $1,820 · 10th to 90th $1,122 to $2,884
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 $1,380.38 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,380.38 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,380.38 | $1,548.82 |
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 $1,071.52 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,071.52 | $2,137.96 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $1,348.96 Typical High $1,819.70 | Professional | 62 · Two surgeons | $676.08 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $346.74 Typical High $512.86 | Professional | 80 · Assistant surgeon | $169.82 | $346.74 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $302.00 Typical High $407.38 | Professional | AS · PA/NP assist | $151.36 | $302.00 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $1,230.27 Median $1,737.80 Typical High $2,951.21 | Professional | None | $1,230.27 | $1,737.80 | $2,951.21 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,235.94 | Facility | None | $912.01 | $2,290.87 | $3,235.94 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,548.82 | $2,089.30 |
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 $1,174.90 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,659.59 | $2,344.23 |
7 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 $630.96 Median $691.83 Typical High $776.25 | Professional | 52 · Reduced service | $630.96 | $691.83 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,047.13 Typical High $1,174.90 | Professional | 54 · Surgery only | $933.25 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $234.42 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $138.04 Typical High $154.88 | Professional | 56 · Pre-op care only | $125.89 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $977.24 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $870.96 | $977.24 | $1,096.48 |
Ambetter Setting Professional Modifier 63 · Small infant Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 63 · Small infant | $1,621.81 | $1,621.81 | $1,621.81 |
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· 13th of 51
$2,138
AK $5,012TX $933
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.