How much rates vary
Facilitymedian $10,471 · 10th to 90th $1,259 to $39,811Professionalmedian $1,202 · 10th to 90th $977 to $1,778
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 $1,202.26 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,202.26 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,412.54 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,380.38 | Professional | None | $954.99 | $1,148.15 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $724.44 Typical High $870.96 | Professional | 62 · Two surgeons | $588.84 | $724.44 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $186.21 Typical High $245.47 | Professional | 80 · Assistant surgeon | $151.36 | $186.21 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $162.18 Typical High $194.98 | Professional | AS · PA/NP assist | $131.83 | $162.18 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $5,370.32 Typical High $10,715.19 | Facility | None | $676.08 | $5,370.32 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,348.96 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $5,754.40 Typical High $15,135.61 | Facility | None | $954.99 | $5,754.40 | $15,135.61 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,737.80 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $8,912.51 Typical High $16,218.10 | Facility | None | $1,548.82 | $8,912.51 | $16,218.10 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,318.26 | $1,995.26 |
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 $602.56 Median $602.56 Typical High $831.76 | Professional | 52 · Reduced service | $602.56 | $602.56 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $331.13 | Professional | 53 · Discontinued | $239.88 | $239.88 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,258.93 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $251.19 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,174.90 |
Where Indiana sits
The same service costs 25.7 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· 43rd of 51
$1,202
AK $5,129TX $200
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.