How much rates vary
Facilitymedian $7,079 · 10th to 90th $794 to $15,488Professionalmedian $1,349 · 10th to 90th $1,148 to $1,995
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 $1,318.26 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,318.26 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,318.26 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $10,000.00 Typical High $16,982.44 | Facility | None | $1,659.59 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,348.96 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $851.14 Typical High $1,023.29 | Professional | 62 · Two surgeons | $691.83 | $851.14 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $218.78 Typical High $288.40 | Professional | 80 · Assistant surgeon | $173.78 | $218.78 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $190.55 Typical High $223.87 | Professional | AS · PA/NP assist | $151.36 | $190.55 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $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 $1,258.93 Median $1,445.44 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,445.44 | $2,630.27 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,548.13 | Facility | None | $912.01 | $2,290.87 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,862.09 | $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 $1,148.15 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,412.54 | $2,137.96 |
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 $660.69 Median $660.69 Typical High $912.01 | Professional | 52 · Reduced service | $660.69 | $660.69 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | 53 · Discontinued | $263.03 | $263.03 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,348.96 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $269.15 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $181.97 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,258.93 |
Where Indiana sits
The same service costs 5.2 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
$1,349
AK $4,786TX $912
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.