How much rates vary
Facilitymedian $5,754 · 10th to 90th $676 to $15,136Professionalmedian $4,467 · 10th to 90th $3,631 to $6,457
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 $2,344.23 Median $4,073.80 Typical High $5,011.87 | Facility | None | $2,344.23 | $4,073.80 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $5,623.41 | Professional | None | $4,073.80 | $4,073.80 | $5,623.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,230.27 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,630.78 Median $4,677.35 Typical High $5,248.07 | Professional | None | $3,630.78 | $4,677.35 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,238.72 Median $2,951.21 Typical High $3,388.44 | Professional | 62 · Two surgeons | $2,238.72 | $2,951.21 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $575.44 Median $741.31 Typical High $977.24 | Professional | 80 · Assistant surgeon | $575.44 | $741.31 | $977.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $501.19 Median $660.69 Typical High $741.31 | Professional | AS · PA/NP assist | $501.19 | $660.69 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Facility | None | $4,365.16 | $4,365.16 | $4,365.16 |
CareSource Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
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 $4,073.80 Median $4,570.88 Typical High $8,709.64 | Professional | None | $4,073.80 | $4,570.88 | $8,709.64 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $5,370.32 Typical High $11,220.18 | Facility | None | $912.01 | $5,370.32 | $11,220.18 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $4,466.84 Median $5,888.44 Typical High $7,244.36 | Professional | None | $4,466.84 | $5,888.44 | $7,244.36 |
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 $3,630.78 Median $4,265.80 Typical High $6,606.93 | Professional | None | $3,630.78 | $4,265.80 | $6,606.93 |
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 $2,041.74 Median $2,041.74 Typical High $2,818.38 | Professional | 52 · Reduced service | $2,041.74 | $2,041.74 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $812.83 Typical High $1,122.02 | Professional | 53 · Discontinued | $812.83 | $812.83 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,019.95 Typical High $4,265.80 | Professional | 54 · Surgery only | $3,019.95 | $3,019.95 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $616.60 Typical High $851.14 | Professional | 55 · Aftercare only | $616.60 | $616.60 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $562.34 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $2,818.38 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $2,818.38 | $2,818.38 | $3,981.07 |
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· 36th of 51
$4,467
AK $14,125TX $676
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.