How much rates vary
Facilitymedian $7,079 · 10th to 90th $794 to $15,488Professionalmedian $1,047 · 10th to 90th $871 to $1,479
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 $977.24 Median $3,467.37 Typical High $5,011.87 | Facility | None | $977.24 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $977.24 Typical High $1,318.26 | Professional | None | $954.99 | $977.24 | $1,318.26 |
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 $870.96 Median $1,071.52 Typical High $1,258.93 | Professional | None | $870.96 | $1,071.52 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $676.08 Typical High $794.33 | Professional | 62 · Two surgeons | $549.54 | $676.08 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $173.78 Typical High $229.09 | Professional | 80 · Assistant surgeon | $138.04 | $173.78 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $151.36 Typical High $177.83 | Professional | AS · PA/NP assist | $120.23 | $151.36 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
CareSource Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
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 $933.25 Median $1,047.13 Typical High $1,905.46 | Professional | None | $933.25 | $1,047.13 | $1,905.46 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,187.76 Typical High $2,691.53 | Facility | None | $912.01 | $2,187.76 | $2,691.53 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,380.38 | $1,737.80 |
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 $851.14 Median $1,023.29 Typical High $1,584.89 | Professional | None | $851.14 | $1,023.29 | $1,584.89 |
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 $478.63 Median $478.63 Typical High $660.69 | Professional | 52 · Reduced service | $478.63 | $478.63 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $194.98 Typical High $263.03 | Professional | 53 · Discontinued | $190.55 | $194.98 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $977.24 | Professional | 54 · Surgery only | $724.44 | $724.44 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $194.98 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $97.72 Typical High $131.83 | Professional | 56 · Pre-op care only | $95.50 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $912.01 |
Where Indiana sits
The same service costs 4.9 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· 37th of 51
$1,072
AK $3,548TX $724
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.