How much rates vary
Facilitymedian $6,761 · 10th to 90th $813 to $14,125Professionalmedian $2,399 · 10th to 90th $2,042 to $3,548
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 $2,398.83 Median $2,951.21 Typical High $5,011.87 | Facility | None | $2,398.83 | $2,951.21 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,311.31 | Professional | None | $2,398.83 | $2,398.83 | $3,311.31 |
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 $1,905.46 Median $2,398.83 Typical High $2,818.38 | Professional | None | $1,905.46 | $2,398.83 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,513.56 Typical High $1,778.28 | Professional | 62 · Two surgeons | $1,202.26 | $1,513.56 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $380.19 Typical High $501.19 | Professional | 80 · Assistant surgeon | $302.00 | $380.19 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $331.13 Typical High $398.11 | Professional | AS · PA/NP assist | $269.15 | $331.13 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
CareSource Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $2,238.72 Median $2,630.27 Typical High $4,677.35 | Professional | None | $2,238.72 | $2,630.27 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,235.94 Typical High $6,606.93 | Facility | None | $912.01 | $3,235.94 | $6,606.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,630.27 Median $3,467.37 Typical High $4,168.69 | Professional | None | $2,630.27 | $3,467.37 | $4,168.69 |
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 $2,089.30 Median $2,570.40 Typical High $3,890.45 | Professional | None | $2,089.30 | $2,570.40 | $3,890.45 |
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 $1,202.26 Median $1,202.26 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $660.69 | Professional | 53 · Discontinued | $478.63 | $478.63 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $331.13 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $2,344.23 |
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· 45th of 51
$2,399
AK $8,710TX $1,622
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.