How much rates vary
Facilitymedian $7,079 · 10th to 90th $794 to $15,488Professionalmedian $1,230 · 10th to 90th $955 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 $1,096.48 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,096.48 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,513.56 | Professional | None | $1,096.48 | $1,096.48 | $1,513.56 |
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 $954.99 Median $1,380.38 Typical High $1,737.80 | Professional | None | $954.99 | $1,380.38 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $870.96 Typical High $1,096.48 | Professional | 62 · Two surgeons | $602.56 | $870.96 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $218.78 Typical High $288.40 | Professional | 80 · Assistant surgeon | $151.36 | $218.78 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $194.98 Typical High $245.47 | Professional | AS · PA/NP assist | $134.90 | $194.98 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
CareSource Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
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 $1,122.02 Median $1,348.96 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,348.96 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $2,951.21 | Facility | None | $912.01 | $2,290.87 | $2,951.21 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,584.89 | $1,949.84 |
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 $954.99 Median $1,202.26 Typical High $1,819.70 | Professional | None | $954.99 | $1,202.26 | $1,819.70 |
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 $549.54 Median $549.54 Typical High $758.58 | Professional | 52 · Reduced service | $549.54 | $549.54 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | 53 · Discontinued | $218.78 | $218.78 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $1,122.02 | Professional | 54 · Surgery only | $812.83 | $812.83 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $229.09 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $151.36 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $1,047.13 |
Where Indiana sits
The same service costs 5.6 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· 34th of 51
$1,288
AK $4,266TX $759
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.