How much rates vary
Facilitymedian $7,079 · 10th to 90th $813 to $15,136Professionalmedian $891 · 10th to 90th $741 to $1,549
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 $870.96 Median $5,011.87 Typical High $16,595.87 | Facility | None | $870.96 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,202.26 | Professional | None | $870.96 | $870.96 | $1,202.26 |
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 $741.31 Median $870.96 Typical High $1,318.26 | Professional | None | $741.31 | $870.96 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,288.25 Typical High $1,949.84 | Professional | 50 · Both sides | $1,096.48 | $1,288.25 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $549.54 Typical High $812.83 | Professional | 62 · Two surgeons | $467.74 | $549.54 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $138.04 Typical High $213.80 | Professional | 80 · Assistant surgeon | $117.49 | $138.04 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $120.23 Typical High $181.97 | Professional | AS · PA/NP assist | $102.33 | $120.23 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,202.26 Typical High $2,691.53 | Facility | None | $562.34 | $1,202.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,737.80 | Professional | None | $891.25 | $1,148.15 | $1,737.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,511.89 | Facility | None | $912.01 | $2,089.30 | $2,511.89 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $1,737.80 | Professional | None | $977.24 | $1,412.54 | $1,737.80 |
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 $1,122.02 Typical High $1,778.28 | Professional | None | $891.25 | $1,122.02 | $1,778.28 |
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 $436.52 Median $436.52 Typical High $602.56 | Professional | 52 · Reduced service | $436.52 | $436.52 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $239.88 | Professional | 53 · Discontinued | $177.83 | $177.83 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $891.25 | Professional | 54 · Surgery only | $660.69 | $660.69 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $177.83 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $831.76 |
Where Indiana sits
The same service costs 6.6 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· 39th of 51
$1,047
AK $3,802TX $575
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.