How much rates vary
Facilitymedian $6,761 · 10th to 90th $813 to $14,125Professionalmedian $1,585 · 10th to 90th $1,318 to $2,239
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 $1,513.56 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,513.56 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,479.11 | $1,513.56 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $8,511.38 Typical High $16,595.87 | Facility | None | $1,659.59 | $8,511.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,584.89 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,000.00 Typical High $1,148.15 | Professional | 62 · Two surgeons | $794.33 | $1,000.00 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $251.19 Typical High $331.13 | Professional | 80 · Assistant surgeon | $204.17 | $251.19 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $223.87 Typical High $257.04 | Professional | AS · PA/NP assist | $177.83 | $223.87 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
CareSource Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,819.70 Typical High $3,019.95 | Facility | None | $562.34 | $1,819.70 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $3,019.95 | Professional | None | $1,445.44 | $1,698.24 | $3,019.95 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $4,168.69 | Facility | None | $912.01 | $2,290.87 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,621.81 | $2,137.96 | $2,754.23 |
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 $1,318.26 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,318.26 | $1,621.81 | $2,511.89 |
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 $741.31 Median $758.58 Typical High $1,000.00 | Professional | 52 · Reduced service | $741.31 | $758.58 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $398.11 | Professional | 53 · Discontinued | $302.00 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $229.09 Typical High $302.00 | Professional | 55 · Aftercare only | $223.87 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $151.36 Typical High $199.53 | Professional | 56 · Pre-op care only | $147.91 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,412.54 |
Where Indiana sits
The same service costs 22.9 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· 39th of 51
$1,585
AK $5,495TX $240
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.