How much rates vary
Facilitymedian $11,482 · 10th to 90th $1,445 to $22,909Professionalmedian $1,445 · 10th to 90th $1,072 to $2,138
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 $1,445.44 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,445.44 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,445.44 | $2,041.74 |
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 $1,071.52 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,258.93 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $794.33 Typical High $977.24 | Professional | 62 · Two surgeons | $676.08 | $794.33 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $204.17 Typical High $269.15 | Professional | 80 · Assistant surgeon | $169.82 | $204.17 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $177.83 Typical High $213.80 | Professional | AS · PA/NP assist | $151.36 | $177.83 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
CareSource Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $1,348.96 Median $1,737.80 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,737.80 | $2,951.21 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,981.07 | Facility | None | $912.01 | $2,290.87 | $3,981.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,584.89 | $2,089.30 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,584.89 | $2,511.89 |
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 $724.44 Median $724.44 Typical High $1,023.29 | Professional | 52 · Reduced service | $724.44 | $724.44 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $407.38 | Professional | 53 · Discontinued | $288.40 | $288.40 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $204.17 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,412.54 |
Where Indiana sits
The same service costs 6.3 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· 44th of 51
$1,445
AK $6,166TX $977
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.