How much rates vary
Facilitymedian $7,079 · 10th to 90th $794 to $15,488Professionalmedian $1,259 · 10th to 90th $1,023 to $1,862
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 $1,258.93 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,258.93 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,258.93 | $1,737.80 |
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 $1,000.00 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,202.26 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $758.58 Typical High $912.01 | Professional | 62 · Two surgeons | $630.96 | $758.58 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $251.19 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $204.17 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
CareSource Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
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 $1,148.15 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,380.38 | $2,454.71 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,467.37 | Facility | None | $912.01 | $2,290.87 | $3,467.37 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,819.70 | $2,187.76 |
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 $1,096.48 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,348.96 | $2,041.74 |
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 $630.96 Median $630.96 Typical High $870.96 | Professional | 52 · Reduced service | $630.96 | $630.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | 53 · Discontinued | $251.19 | $251.19 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $263.03 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,230.27 |
Where Indiana sits
The same service costs 5.4 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· 44th of 51
$1,259
AK $4,571TX $851
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.