How much rates vary
Facilitymedian $7,079 · 10th to 90th $794 to $15,488Professionalmedian $1,778 · 10th to 90th $1,514 to $2,630
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 $1,737.80 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,737.80 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,737.80 | $1,737.80 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $10,000.00 Typical High $16,982.44 | Facility | None | $1,698.24 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,778.28 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,122.02 Typical High $1,348.96 | Professional | 62 · Two surgeons | $891.25 | $1,122.02 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $288.40 Typical High $380.19 | Professional | 80 · Assistant surgeon | $229.09 | $288.40 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $251.19 Typical High $302.00 | Professional | AS · PA/NP assist | $199.53 | $251.19 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
CareSource Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $4,786.30 | Facility | None | $512.86 | $851.14 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $3,548.13 | Professional | None | $1,698.24 | $1,949.84 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $4,786.30 | Facility | None | $912.01 | $2,290.87 | $4,786.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $3,019.95 | Professional | None | $1,862.09 | $2,454.71 | $3,019.95 |
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 $1,513.56 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,513.56 | $1,862.09 | $2,818.38 |
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 $870.96 Median $870.96 Typical High $1,202.26 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $478.63 | Professional | 53 · Discontinued | $346.74 | $346.74 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $363.08 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $239.88 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,698.24 |
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· 42nd of 51
$1,778
AK $6,310TX $1,175
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.