How much rates vary
Facilitymedian $7,079 · 10th to 90th $794 to $15,488Professionalmedian $2,512 · 10th to 90th $2,042 to $3,548
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 $2,344.23 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,344.23 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $3,311.31 | Professional | None | $2,344.23 | $2,344.23 | $3,311.31 |
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 $2,041.74 Median $2,511.89 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,511.89 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,584.89 Typical High $1,819.70 | Professional | 62 · Two surgeons | $1,288.25 | $1,584.89 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $407.38 Typical High $537.03 | Professional | 80 · Assistant surgeon | $323.59 | $407.38 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $354.81 Typical High $407.38 | Professional | AS · PA/NP assist | $281.84 | $354.81 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
CareSource Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $2,290.87 Median $2,630.27 Typical High $4,677.35 | Professional | None | $2,290.87 | $2,630.27 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,090.30 Typical High $6,456.54 | Facility | None | $912.01 | $3,090.30 | $6,456.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,570.40 Median $3,388.44 Typical High $4,168.69 | Professional | None | $2,570.40 | $3,388.44 | $4,168.69 |
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 $2,089.30 Median $2,570.40 Typical High $3,890.45 | Professional | None | $2,089.30 | $2,570.40 | $3,890.45 |
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 $1,174.90 Median $1,174.90 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $660.69 | Professional | 53 · Discontinued | $467.74 | $467.74 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $489.78 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $331.13 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $2,290.87 |
Where Indiana sits
The same service costs 21.4 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· 39th of 51
$2,512
AK $8,318TX $389
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.