How much rates vary
Facilitymedian $9,772 · 10th to 90th $832 to $21,878Professionalmedian $1,738 · 10th to 90th $1,230 to $2,512
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 $1,348.96 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,348.96 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,348.96 | $1,778.28 |
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 $1,230.27 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,737.80 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,096.48 Typical High $1,479.11 | Professional | 62 · Two surgeons | $776.25 | $1,096.48 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $281.84 Typical High $398.11 | Professional | 80 · Assistant surgeon | $199.53 | $281.84 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $245.47 Typical High $331.13 | Professional | AS · PA/NP assist | $173.78 | $245.47 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $1,412.54 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,412.54 | $1,737.80 | $3,019.95 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,890.45 | Facility | None | $912.01 | $2,290.87 | $3,890.45 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,548.82 Median $2,187.76 Typical High $2,754.23 | Professional | None | $1,548.82 | $2,187.76 | $2,754.23 |
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 $1,288.25 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,659.59 | $2,630.27 |
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 $676.08 Median $676.08 Typical High $891.25 | Professional | 52 · Reduced service | $676.08 | $676.08 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $354.81 | Professional | 53 · Discontinued | $269.15 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $177.83 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,258.93 |
Where Indiana sits
The same service costs 5.6 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· 34th of 51
$1,738
AK $6,026UT $1,072
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.