How much rates vary
Facilitymedian $9,772 · 10th to 90th $832 to $21,878Professionalmedian $1,148 · 10th to 90th $794 to $1,622
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 $831.76 Median $3,467.37 Typical High $5,011.87 | Facility | None | $831.76 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,096.48 | Professional | None | $831.76 | $831.76 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $14,454.40 Typical High $22,908.68 | Facility | None | $1,862.09 | $14,454.40 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,548.82 | Professional | None | $758.58 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $724.44 Typical High $977.24 | Professional | 62 · Two surgeons | $478.63 | $724.44 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $186.21 Typical High $263.03 | Professional | 80 · Assistant surgeon | $120.23 | $186.21 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $162.18 Typical High $218.78 | Professional | AS · PA/NP assist | $107.15 | $162.18 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | 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 $851.14 Median $1,122.02 Typical High $1,819.70 | Professional | None | $851.14 | $1,122.02 | $1,819.70 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,398.83 | Facility | None | $912.01 | $2,089.30 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $1,698.24 | Professional | None | $933.25 | $1,348.96 | $1,698.24 |
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 $812.83 Median $1,071.52 Typical High $1,698.24 | Professional | None | $812.83 | $1,071.52 | $1,698.24 |
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 $416.87 Median $416.87 Typical High $549.54 | Professional | 52 · Reduced service | $416.87 | $416.87 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $218.78 | Professional | 53 · Discontinued | $165.96 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $812.83 | Professional | 54 · Surgery only | $630.96 | $630.96 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $162.18 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $758.58 |
Where Indiana sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 32nd of 51
$1,148
AK $3,631UT $631
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.