How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,175 to $19,498Professionalmedian $1,148 · 10th to 90th $891 to $1,738
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 $1,096.48 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,096.48 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,096.48 | $1,348.96 |
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 $812.83 Median $1,148.15 Typical High $1,621.81 | Professional | None | $812.83 | $1,148.15 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,737.80 Typical High $2,454.71 | Professional | 50 · Both sides | $1,230.27 | $1,737.80 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $724.44 Typical High $1,023.29 | Professional | 62 · Two surgeons | $512.86 | $724.44 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $181.97 Typical High $275.42 | Professional | 80 · Assistant surgeon | $128.82 | $181.97 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $162.18 Typical High $229.09 | Professional | AS · PA/NP assist | $114.82 | $162.18 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,630.78 Typical High $6,760.83 | Facility | None | $645.65 | $3,630.78 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $2,089.30 | Professional | None | $933.25 | $1,318.26 | $2,089.30 |
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 $1,000.00 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,202.26 | $1,621.81 |
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 $954.99 Median $1,348.96 Typical High $1,949.84 | Professional | None | $954.99 | $1,348.96 | $1,949.84 |
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 $501.19 Median $549.54 Typical High $616.60 | Professional | 52 · Reduced service | $501.19 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $245.47 | Professional | 53 · Discontinued | $199.53 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $186.21 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $123.03 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $870.96 |
Where Indiana sits
The same service costs 5.0 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· 39th of 51
$1,380
WI $4,365TX $871
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.