How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,175 to $19,498Professionalmedian $1,175 · 10th to 90th $912 to $1,820
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 $1,122.02 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,122.02 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,122.02 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $11,481.54 Typical High $23,988.33 | Facility | None | $1,479.11 | $11,481.54 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,659.59 | Professional | None | $831.76 | $1,174.90 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,778.28 Typical High $2,511.89 | Professional | 50 · Both sides | $1,258.93 | $1,778.28 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $741.31 Typical High $1,047.13 | Professional | 62 · Two surgeons | $524.81 | $741.31 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $190.55 Typical High $281.84 | Professional | 80 · Assistant surgeon | $134.90 | $190.55 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $165.96 Typical High $234.42 | Professional | AS · PA/NP assist | $117.49 | $165.96 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,715.35 Typical High $6,760.83 | Facility | None | $645.65 | $3,715.35 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $2,238.72 | Professional | None | $954.99 | $1,412.54 | $2,238.72 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,162.28 Typical High $8,128.31 | Facility | None | $954.99 | $3,162.28 | $8,128.31 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,258.93 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,412.54 | $2,041.74 |
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 $512.86 Median $562.34 Typical High $676.08 | Professional | 52 · Reduced service | $512.86 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $223.87 Typical High $269.15 | Professional | 53 · Discontinued | $204.17 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $851.14 Typical High $1,000.00 | Professional | 54 · Surgery only | $776.25 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $169.82 Typical High $204.17 | Professional | 55 · Aftercare only | $154.88 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $112.20 Typical High $134.90 | Professional | 56 · Pre-op care only | $102.33 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $794.33 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $724.44 | $794.33 | $933.25 |
Where Indiana sits
The same service costs 5.1 times more in Wisconsin 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· 40th of 51
$1,413
WI $4,677TX $912
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.