How much rates vary
Facilitymedian $2,754 · 10th to 90th $631 to $8,318Professionalmedian $631 · 10th to 90th $501 to $912
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 $549.54 Median $3,467.37 Typical High $5,011.87 | Facility | None | $549.54 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $741.31 | Professional | None | $549.54 | $549.54 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $741.31 Typical High $831.76 | Professional | None | $501.19 | $741.31 | $831.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $467.74 Typical High $524.81 | Professional | 62 · Two surgeons | $316.23 | $467.74 | $524.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $117.49 Typical High $154.88 | Professional | 80 · Assistant surgeon | $79.43 | $117.49 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $104.71 Typical High $117.49 | Professional | AS · PA/NP assist | $69.18 | $104.71 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
CareSource Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,659.59 | Facility | None | $446.68 | $977.24 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $1,202.26 | Professional | None | $562.34 | $676.08 | $1,202.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,513.56 Typical High $2,290.87 | Facility | None | $912.01 | $1,513.56 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,000.00 | Professional | None | $616.60 | $794.33 | $1,000.00 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $912.01 | Professional | None | $478.63 | $575.44 | $912.01 |
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 $269.15 Median $269.15 Typical High $371.54 | Professional | 52 · Reduced service | $269.15 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $151.36 | Professional | 53 · Discontinued | $109.65 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $562.34 | Professional | 54 · Surgery only | $407.38 | $407.38 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $112.20 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $74.13 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $524.81 |
Where Indiana sits
The same service costs 5.5 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
$646
AK $2,188TX $398
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.