How much rates vary
Facilitymedian $7,079 · 10th to 90th $813 to $15,136Professionalmedian $1,349 · 10th to 90th $1,122 to $1,995
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 $1,348.96 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,348.96 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,348.96 | $1,862.09 |
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 $1,047.13 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,318.26 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $831.76 Typical High $977.24 | Professional | 62 · Two surgeons | $660.69 | $831.76 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $208.93 Typical High $275.42 | Professional | 80 · Assistant surgeon | $165.96 | $208.93 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $181.97 Typical High $218.78 | Professional | AS · PA/NP assist | $147.91 | $181.97 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,621.81 Typical High $2,691.53 | Facility | None | $562.34 | $1,621.81 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,513.56 | $2,691.53 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,715.35 | Facility | None | $912.01 | $2,290.87 | $3,715.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,479.11 | $1,949.84 | $2,398.83 |
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 $1,202.26 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,445.44 | $2,238.72 |
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 $676.08 Median $676.08 Typical High $933.25 | Professional | 52 · Reduced service | $676.08 | $676.08 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $380.19 | Professional | 53 · Discontinued | $269.15 | $269.15 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $281.84 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $186.21 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,318.26 |
Where Indiana sits
The same service costs 5.2 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· 45th of 51
$1,349
AK $4,898TX $933
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.