How much rates vary
Facilitymedian $7,079 · 10th to 90th $813 to $15,136Professionalmedian $1,445 · 10th to 90th $1,122 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 $1,659.59 Median $10,000.00 Typical High $16,982.44 | Facility | None | $1,659.59 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,318.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $831.76 Typical High $1,023.29 | Professional | 62 · Two surgeons | $707.95 | $831.76 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $213.80 Typical High $281.84 | Professional | 80 · Assistant surgeon | $181.97 | $213.80 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $186.21 Typical High $223.87 | Professional | AS · PA/NP assist | $154.88 | $186.21 | $223.87 |
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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,737.80 Typical High $2,818.38 | Facility | None | $562.34 | $1,737.80 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,621.81 | $2,884.03 |
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 $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 $1,288.25 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,584.89 | $2,398.83 |
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 20.9 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· 43rd of 51
$1,445
AK $5,129TX $245
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.