How much rates vary
Facilitymedian $10,715 · 10th to 90th $832 to $22,909Professionalmedian $3,802 · 10th to 90th $2,399 to $6,166
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 $4,265.80 Typical High $5,011.87 | Facility | None | $2,344.23 | $4,265.80 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $5,888.44 | Professional | None | $4,265.80 | $4,265.80 | $5,888.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $15,135.61 Typical High $24,547.09 | Facility | None | $2,041.74 | $15,135.61 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $3,801.89 | Professional | None | $2,398.83 | $2,818.38 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $1,778.28 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,513.56 | $1,778.28 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $457.09 Typical High $645.65 | Professional | 80 · Assistant surgeon | $389.05 | $457.09 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $398.11 Typical High $537.03 | Professional | AS · PA/NP assist | $338.84 | $398.11 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Facility | None | $4,570.88 | $4,570.88 | $4,570.88 |
CareSource Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $4,677.35 Typical High $9,120.11 | Professional | None | $2,344.23 | $4,677.35 | $9,120.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $5,623.41 Typical High $11,481.54 | Facility | None | $912.01 | $5,623.41 | $11,481.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $4,365.16 Median $6,025.60 Typical High $7,585.78 | Professional | None | $4,365.16 | $6,025.60 | $7,585.78 |
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 $3,630.78 Median $4,570.88 Typical High $7,244.36 | Professional | None | $3,630.78 | $4,570.88 | $7,244.36 |
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 $2,137.96 Median $2,137.96 Typical High $2,951.21 | Professional | 52 · Reduced service | $2,137.96 | $2,137.96 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | 53 · Discontinued | $851.14 | $851.14 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,162.28 Typical High $4,466.84 | Professional | 54 · Surgery only | $3,162.28 | $3,162.28 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $630.96 Typical High $891.25 | Professional | 55 · Aftercare only | $630.96 | $630.96 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | 56 · Pre-op care only | $426.58 | $426.58 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $2,951.21 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $2,951.21 | $2,951.21 | $4,168.69 |
Where Indiana sits
The same service costs 21.9 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· 45th of 51
$3,802
AK $15,136TX $692
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.