How much rates vary
Facilitymedian $6,457 · 10th to 90th $813 to $14,125Professionalmedian $1,380 · 10th to 90th $1,122 to $1,950
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 $1,258.93 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,258.93 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,258.93 | $1,698.24 |
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 $1,122.02 Median $1,445.44 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,445.44 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $912.01 Typical High $1,047.13 | Professional | 62 · Two surgeons | $707.95 | $912.01 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $229.09 Typical High $302.00 | Professional | 80 · Assistant surgeon | $177.83 | $229.09 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $204.17 Typical High $229.09 | Professional | AS · PA/NP assist | $154.88 | $204.17 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
CareSource Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,819.70 Typical High $2,691.53 | Facility | None | $575.44 | $1,819.70 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,445.44 | $2,691.53 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,467.37 | Facility | None | $912.01 | $2,290.87 | $3,467.37 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,380.38 | $1,819.70 | $2,290.87 |
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 $1,122.02 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,380.38 | $2,089.30 |
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 $630.96 Median $630.96 Typical High $851.14 | Professional | 52 · Reduced service | $630.96 | $630.96 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $338.84 | Professional | 53 · Discontinued | $251.19 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $954.99 Typical High $1,258.93 | Professional | 54 · Surgery only | $933.25 | $954.99 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $190.55 Typical High $251.19 | Professional | 55 · Aftercare only | $186.21 | $190.55 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $891.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $870.96 | $891.25 | $1,174.90 |
Where Indiana sits
The same service costs 5.4 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· 35th of 51
$1,413
AK $4,571TX $851
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.