How much rates vary
Facilitymedian $10,471 · 10th to 90th $832 to $22,909Professionalmedian $1,380 · 10th to 90th $1,175 to $2,042
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 $1,348.96 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,348.96 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,348.96 | $1,862.09 |
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 $1,096.48 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,380.38 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $870.96 Typical High $1,023.29 | Professional | 62 · Two surgeons | $691.83 | $870.96 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $223.87 Typical High $295.12 | Professional | 80 · Assistant surgeon | $177.83 | $223.87 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $194.98 Typical High $229.09 | Professional | AS · PA/NP assist | $154.88 | $194.98 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $1,258.93 Median $1,513.56 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,513.56 | $2,630.27 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,630.78 | Facility | None | $912.01 | $2,290.87 | $3,630.78 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,445.44 | $1,905.46 | $2,344.23 |
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 $1,174.90 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,479.11 | $2,187.76 |
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 $660.69 Median $660.69 Typical High $933.25 | Professional | 52 · Reduced service | $660.69 | $660.69 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $371.54 | Professional | 53 · Discontinued | $269.15 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $281.84 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $186.21 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,288.25 |
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· 43rd of 51
$1,380
AK $4,898TX $891
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.