How much rates vary
Facilitymedian $10,471 · 10th to 90th $832 to $22,909Professionalmedian $3,090 · 10th to 90th $2,455 to $4,467
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 $2,754.23 Median $2,754.23 Typical High $3,890.45 | Professional | None | $2,754.23 | $2,754.23 | $3,890.45 |
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 $2,454.71 Median $3,388.44 Typical High $3,890.45 | Professional | None | $2,454.71 | $3,388.44 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $2,137.96 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,548.82 | $2,137.96 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $549.54 Typical High $724.44 | Professional | 80 · Assistant surgeon | $389.05 | $549.54 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $478.63 Typical High $537.03 | Professional | AS · PA/NP assist | $338.84 | $478.63 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
CareSource Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
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 $2,754.23 Median $3,235.94 Typical High $5,495.41 | Professional | None | $2,754.23 | $3,235.94 | $5,495.41 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,715.35 Typical High $7,585.78 | Facility | None | $912.01 | $3,715.35 | $7,585.78 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3,019.95 Median $3,981.07 Typical High $4,897.79 | Professional | None | $3,019.95 | $3,981.07 | $4,897.79 |
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 $2,344.23 Median $2,951.21 Typical High $4,466.84 | Professional | None | $2,344.23 | $2,951.21 | $4,466.84 |
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 $1,380.38 Median $1,380.38 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $776.25 | Professional | 53 · Discontinued | $549.54 | $549.54 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $575.44 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $389.05 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $2,691.53 |
Where Indiana sits
The same service costs 21.4 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
$3,162
AK $9,772TX $457
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.