How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,047 to $14,454Professionalmedian $1,047 · 10th to 90th $832 to $1,622
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 $1,071.52 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,071.52 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,288.25 | Professional | None | $977.24 | $1,071.52 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,148.15 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,479.11 | Professional | None | $794.33 | $1,047.13 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $660.69 Typical High $933.25 | Professional | 62 · Two surgeons | $501.19 | $660.69 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $165.96 Typical High $251.19 | Professional | 80 · Assistant surgeon | $125.89 | $165.96 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $144.54 Typical High $208.93 | Professional | AS · PA/NP assist | $109.65 | $144.54 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,137.96 Typical High $3,467.37 | Facility | None | $645.65 | $2,137.96 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $2,089.30 | Professional | None | $912.01 | $1,318.26 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $2,454.71 Typical High $4,570.88 | Facility | None | $954.99 | $2,454.71 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,584.89 | Professional | None | $977.24 | $1,174.90 | $1,584.89 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $1,949.84 | Professional | None | $933.25 | $1,318.26 | $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 $489.78 Median $537.03 Typical High $602.56 | Professional | 52 · Reduced service | $489.78 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $213.80 Typical High $239.88 | Professional | 53 · Discontinued | $194.98 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $794.33 Typical High $891.25 | Professional | 54 · Surgery only | $724.44 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $158.49 Typical High $181.97 | Professional | 55 · Aftercare only | $144.54 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $107.15 Typical High $120.23 | Professional | 56 · Pre-op care only | $97.72 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $741.31 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $676.08 | $741.31 | $831.76 |
Where Indiana sits
The same service costs 4.6 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
$1,259
WI $3,981TX $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.