How much rates vary
Facilitymedian $2,239 · 10th to 90th $562 to $5,129Professionalmedian $1,072 · 10th to 90th $708 to $1,514
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 $870.96 Median $3,467.37 Typical High $5,011.87 | Facility | None | $870.96 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,047.13 | Professional | None | $794.33 | $870.96 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,071.52 Typical High $1,445.44 | Professional | None | $645.65 | $1,071.52 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $676.08 Typical High $912.01 | Professional | 62 · Two surgeons | $407.38 | $676.08 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $169.82 Typical High $257.04 | Professional | 80 · Assistant surgeon | $102.33 | $169.82 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $147.91 Typical High $199.53 | Professional | AS · PA/NP assist | $91.20 | $147.91 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $1,949.84 | Facility | None | $645.65 | $1,071.52 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,621.81 | Professional | None | $776.25 | $1,071.52 | $1,621.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,949.84 Typical High $2,290.87 | Facility | None | $912.01 | $1,949.84 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,288.25 | Professional | None | $794.33 | $954.99 | $1,288.25 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,698.24 | Professional | None | $831.76 | $1,122.02 | $1,698.24 |
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 $398.11 Median $436.52 Typical High $512.86 | Professional | 52 · Reduced service | $398.11 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $208.93 | Professional | 53 · Discontinued | $158.49 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $776.25 | Professional | 54 · Surgery only | $588.84 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $154.88 | Professional | 55 · Aftercare only | $120.23 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $102.33 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $724.44 |
Where Indiana sits
The same service costs 4.4 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· 33rd of 51
$1,072
AK $3,020TX $692
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.