How much rates vary
Facilitymedian $7,079 · 10th to 90th $794 to $15,488Professionalmedian $1,148 · 10th to 90th $912 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 $1,023.29 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,023.29 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,023.29 | $1,412.54 |
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 $912.01 Median $1,148.15 Typical High $1,348.96 | Professional | None | $912.01 | $1,148.15 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $724.44 Typical High $851.14 | Professional | 62 · Two surgeons | $575.44 | $724.44 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $186.21 Typical High $245.47 | Professional | 80 · Assistant surgeon | $144.54 | $186.21 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $162.18 Typical High $190.55 | Professional | AS · PA/NP assist | $128.82 | $162.18 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
CareSource Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $1,000.00 Median $1,148.15 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,148.15 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $2,754.23 | Facility | None | $912.01 | $2,290.87 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,445.44 | $1,778.28 |
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 $891.25 Median $1,096.48 Typical High $1,659.59 | Professional | None | $891.25 | $1,096.48 | $1,659.59 |
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 $512.86 Median $512.86 Typical High $707.95 | Professional | 52 · Reduced service | $512.86 | $512.86 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $281.84 | Professional | 53 · Discontinued | $204.17 | $204.17 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $1,047.13 | Professional | 54 · Surgery only | $758.58 | $758.58 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $208.93 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $977.24 |
Where Indiana sits
The same service costs 24.5 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· 35th of 51
$1,148
AK $4,266TX $174
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.