How much rates vary
Facilitymedian $5,248 · 10th to 90th $692 to $25,119Professionalmedian $1,995 · 10th to 90th $1,230 to $3,162
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 $1,548.82 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,548.82 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,737.80 | Professional | None | $1,412.54 | $1,548.82 | $1,737.80 |
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 $1,202.26 Median $2,398.83 Typical High $3,162.28 | Professional | None | $1,202.26 | $2,398.83 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,479.11 Typical High $1,995.26 | Professional | 62 · Two surgeons | $758.58 | $1,479.11 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $380.19 Typical High $562.34 | Professional | 80 · Assistant surgeon | $190.55 | $380.19 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $331.13 Typical High $446.68 | Professional | AS · PA/NP assist | $165.96 | $331.13 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,041.74 Typical High $3,090.30 | Facility | None | $575.44 | $2,041.74 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,380.38 | $1,819.70 | $3,162.28 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,630.78 | Facility | None | $912.01 | $2,290.87 | $3,630.78 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,737.80 | $2,290.87 |
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 $1,318.26 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,862.09 | $2,630.27 |
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 $707.95 Median $776.25 Typical High $870.96 | Professional | 52 · Reduced service | $707.95 | $776.25 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $309.03 Typical High $346.74 | Professional | 53 · Discontinued | $281.84 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,174.90 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,047.13 | $1,174.90 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $234.42 Typical High $263.03 | Professional | 55 · Aftercare only | $208.93 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $154.88 Typical High $173.78 | Professional | 56 · Pre-op care only | $141.25 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,096.48 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $977.24 | $1,096.48 | $1,230.27 |
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· 14th of 51
$2,291
AK $5,495TX $1,023
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.