How much rates vary
Facilitymedian $9,333 · 10th to 90th $891 to $22,909Professionalmedian $1,122 · 10th to 90th $871 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 $954.99 Median $3,467.37 Typical High $5,011.87 | Facility | None | $954.99 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None | $954.99 | $954.99 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $15,135.61 Typical High $24,547.09 | Facility | None | $1,862.09 | $15,135.61 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $1,513.56 | Professional | None | $870.96 | $1,318.26 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $831.76 Typical High $954.99 | Professional | 62 · Two surgeons | $549.54 | $831.76 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $213.80 Typical High $275.42 | Professional | 80 · Assistant surgeon | $141.25 | $213.80 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $186.21 Typical High $208.93 | Professional | AS · PA/NP assist | $123.03 | $186.21 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
CareSource Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,348.96 Typical High $2,691.53 | Facility | None | $562.34 | $1,348.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,174.90 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,187.76 Typical High $2,691.53 | Facility | None | $912.01 | $2,187.76 | $2,691.53 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,412.54 | $1,737.80 |
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 $870.96 Median $1,096.48 Typical High $1,659.59 | Professional | None | $870.96 | $1,096.48 | $1,659.59 |
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 $478.63 Median $478.63 Typical High $660.69 | Professional | 52 · Reduced service | $478.63 | $478.63 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $263.03 | Professional | 53 · Discontinued | $190.55 | $190.55 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $1,000.00 | Professional | 54 · Surgery only | $724.44 | $724.44 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $199.53 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $131.83 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $933.25 |
Where Indiana sits
The same service costs 24.5 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· 32nd of 51
$1,175
AK $4,074TX $166
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.