How much rates vary
Facilitymedian $6,761 · 10th to 90th $813 to $14,125Professionalmedian $1,738 · 10th to 90th $1,349 to $2,512
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 $1,513.56 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,513.56 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $8,511.38 Typical High $16,595.87 | Facility | None | $1,698.24 | $8,511.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,348.96 | $1,949.84 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,230.27 Typical High $1,380.38 | Professional | 62 · Two surgeons | $851.14 | $1,230.27 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $309.03 Typical High $407.38 | Professional | 80 · Assistant surgeon | $213.80 | $309.03 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $275.42 Typical High $309.03 | Professional | AS · PA/NP assist | $190.55 | $275.42 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,819.70 Typical High $3,090.30 | Facility | None | $562.34 | $1,819.70 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,513.56 | $1,698.24 | $3,235.94 |
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 $1,659.59 Median $2,187.76 Typical High $2,691.53 | Professional | None | $1,659.59 | $2,187.76 | $2,691.53 |
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 $1,348.96 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,659.59 | $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 $758.58 Median $758.58 Typical High $1,071.52 | Professional | 52 · Reduced service | $758.58 | $758.58 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $426.58 | Professional | 53 · Discontinued | $309.03 | $309.03 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $213.80 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,479.11 |
Where Indiana sits
The same service costs 20.9 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· 34th of 51
$1,738
AK $5,370TX $257
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.