How much rates vary
Facilitymedian $10,233 · 10th to 90th $813 to $25,704Professionalmedian $871 · 10th to 90th $661 to $1,230
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 $741.31 Median $5,011.87 Typical High $17,782.79 | Facility | None | $741.31 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,047.13 | Professional | None | $741.31 | $741.31 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $16,982.44 Typical High $28,183.83 | Facility | None | $2,238.72 | $16,982.44 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $1,148.15 | Professional | None | $660.69 | $1,023.29 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $645.65 Typical High $724.44 | Professional | 62 · Two surgeons | $416.87 | $645.65 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $162.18 Typical High $213.80 | Professional | 80 · Assistant surgeon | $107.15 | $162.18 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $144.54 Typical High $162.18 | Professional | AS · PA/NP assist | $93.33 | $144.54 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $851.14 Typical High $2,691.53 | Facility | None | $575.44 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,479.11 | Professional | None | $758.58 | $870.96 | $1,479.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,995.26 Typical High $2,187.76 | Facility | None | $912.01 | $1,995.26 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,318.26 | Professional | None | $812.83 | $1,071.52 | $1,318.26 |
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 $660.69 Median $812.83 Typical High $1,230.27 | Professional | None | $660.69 | $812.83 | $1,230.27 |
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 $371.54 Median $371.54 Typical High $512.86 | Professional | 52 · Reduced service | $371.54 | $371.54 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | 53 · Discontinued | $147.91 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $776.25 | Professional | 54 · Surgery only | $562.34 | $562.34 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $154.88 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $724.44 |
Where Indiana sits
The same service costs 5.9 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· 33rd of 51
$871
AK $3,162TX $537
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.