How much rates vary
Facilitymedian $6,918 · 10th to 90th $813 to $15,136Professionalmedian $1,318 · 10th to 90th $1,122 to $1,905
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 $1,288.25 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,288.25 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
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 $1,071.52 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,318.26 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $831.76 Typical High $1,000.00 | Professional | 62 · Two surgeons | $676.08 | $831.76 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $213.80 Typical High $281.84 | Professional | 80 · Assistant surgeon | $169.82 | $213.80 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $186.21 Typical High $218.78 | Professional | AS · PA/NP assist | $147.91 | $186.21 | $218.78 |
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 $575.44 Median $1,819.70 Typical High $2,818.38 | Facility | None | $575.44 | $1,819.70 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,412.54 | $2,570.40 |
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 $1,380.38 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,380.38 | $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 $645.65 Median $645.65 Typical High $891.25 | Professional | 52 · Reduced service | $645.65 | $645.65 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $363.08 | Professional | 53 · Discontinued | $257.04 | $257.04 | $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 $128.82 Median $128.82 Typical High $177.83 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $177.83 |
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 5.4 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· 42nd of 51
$1,318
AK $4,677TX $871
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.