How much rates vary
Facilitymedian $7,586 · 10th to 90th $891 to $19,055Professionalmedian $2,138 · 10th to 90th $1,622 to $3,467
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 $2,344.23 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,344.23 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $2,951.21 | Professional | None | $2,344.23 | $2,630.27 | $2,951.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $10,964.78 Typical High $22,387.21 | Facility | None | $2,041.74 | $10,964.78 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,621.81 | $2,041.74 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,288.25 Typical High $1,949.84 | Professional | 62 · Two surgeons | $1,023.29 | $1,288.25 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $331.13 Typical High $512.86 | Professional | 80 · Assistant surgeon | $263.03 | $331.13 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $288.40 Typical High $436.52 | Professional | AS · PA/NP assist | $229.09 | $288.40 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,290.87 Typical High $3,630.78 | Facility | None | $562.34 | $2,290.87 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $3,890.45 | Professional | None | $1,778.28 | $2,454.71 | $3,890.45 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,884.03 Typical High $6,025.60 | Facility | None | $912.01 | $2,884.03 | $6,025.60 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $3,890.45 | Professional | None | $2,344.23 | $2,884.03 | $3,890.45 |
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 $1,621.81 Median $2,818.38 Typical High $4,168.69 | Professional | None | $1,621.81 | $2,818.38 | $4,168.69 |
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 $1,174.90 Median $1,318.26 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,174.90 | $1,318.26 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $524.81 Typical High $588.84 | Professional | 53 · Discontinued | $467.74 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,949.84 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,778.28 | $1,949.84 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $389.05 Typical High $436.52 | Professional | 55 · Aftercare only | $354.81 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $263.03 Typical High $295.12 | Professional | 56 · Pre-op care only | $234.42 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,819.70 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,819.70 | $2,041.74 |
Where Indiana sits
The same service costs 6.2 times more in Alaska than in Delaware. 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
$2,630
AK $9,333DE $1,514
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.