How much rates vary
Facilitymedian $5,495 · 10th to 90th $692 to $21,878Professionalmedian $1,778 · 10th to 90th $1,259 to $2,570
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 $1,621.81 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,621.81 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,445.44 | $1,621.81 | $1,819.70 |
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 $1,258.93 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,778.28 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,691.53 Typical High $3,715.35 | Professional | 50 · Both sides | $1,862.09 | $2,691.53 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,122.02 Typical High $1,584.89 | Professional | 62 · Two surgeons | $794.33 | $1,122.02 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $288.40 Typical High $426.58 | Professional | 80 · Assistant surgeon | $199.53 | $288.40 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $251.19 Typical High $346.74 | Professional | AS · PA/NP assist | $173.78 | $251.19 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,548.82 Typical High $2,951.21 | Facility | None | $562.34 | $1,548.82 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,737.80 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,801.89 | Facility | None | $912.01 | $2,290.87 | $3,801.89 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,513.56 | $1,819.70 | $2,398.83 |
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 $1,348.96 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,905.46 | $2,754.23 |
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 $724.44 Median $812.83 Typical High $891.25 | Professional | 52 · Reduced service | $724.44 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $323.59 Typical High $363.08 | Professional | 53 · Discontinued | $288.40 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,202.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,096.48 | $1,202.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $239.88 Typical High $269.15 | Professional | 55 · Aftercare only | $218.78 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $162.18 Typical High $181.97 | Professional | 56 · Pre-op care only | $144.54 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,122.02 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,122.02 | $1,258.93 |
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· 34th of 51
$1,778
AK $5,754TX $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.