How much rates vary
Facilitymedian $7,586 · 10th to 90th $891 to $19,055Professionalmedian $1,413 · 10th to 90th $1,072 to $2,138
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 $1,445.44 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,445.44 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,445.44 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $10,964.78 Typical High $22,387.21 | Facility | None | $1,862.09 | $10,964.78 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,023.29 | $1,258.93 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,905.46 Typical High $2,884.03 | Professional | 50 · Both sides | $1,548.82 | $1,905.46 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $794.33 Typical High $1,230.27 | Professional | 62 · Two surgeons | $645.65 | $794.33 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $204.17 Typical High $316.23 | Professional | 80 · Assistant surgeon | $173.78 | $204.17 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $177.83 Typical High $269.15 | Professional | AS · PA/NP assist | $141.25 | $177.83 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,698.24 Typical High $2,754.23 | Facility | None | $575.44 | $1,698.24 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,659.59 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,311.31 | Facility | None | $912.01 | $2,290.87 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,584.89 | $2,137.96 |
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 $1,288.25 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,778.28 | $2,630.27 |
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 $660.69 Median $724.44 Typical High $812.83 | Professional | 52 · Reduced service | $660.69 | $724.44 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $288.40 Typical High $331.13 | Professional | 53 · Discontinued | $263.03 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $245.47 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $144.54 Typical High $162.18 | Professional | 56 · Pre-op care only | $131.83 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,148.15 |
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· 35th of 51
$1,622
AK $5,248TX $933
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.