How much rates vary
Facilitymedian $3,548 · 10th to 90th $741 to $8,128Professionalmedian $1,047 · 10th to 90th $724 to $1,585
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 $1,122.02 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,122.02 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,122.02 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $5,370.32 Typical High $9,120.11 | Facility | None | $1,380.38 | $5,370.32 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,071.52 | Professional | None | $676.08 | $812.83 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $501.19 Typical High $676.08 | Professional | 62 · Two surgeons | $426.58 | $501.19 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $128.82 Typical High $173.78 | Professional | 80 · Assistant surgeon | $109.65 | $128.82 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $112.20 Typical High $147.91 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $954.99 Typical High $2,398.83 | Facility | None | $691.83 | $954.99 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,187.76 | Professional | None | $954.99 | $1,230.27 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,090.30 | Facility | None | $912.01 | $2,290.87 | $3,090.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,202.26 | $1,584.89 | $1,949.84 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,819.70 | Professional | None | $954.99 | $1,202.26 | $1,819.70 |
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 $562.34 Median $562.34 Typical High $776.25 | Professional | 52 · Reduced service | $562.34 | $562.34 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | 53 · Discontinued | $223.87 | $223.87 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,148.15 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $154.88 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $1,071.52 |
Where Indiana sits
The same service costs 5.5 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
$1,072
AK $4,266TX $776
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.