How much rates vary
Facilitymedian $3,981 · 10th to 90th $724 to $9,772Professionalmedian $741 · 10th to 90th $501 to $1,072
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 $549.54 Median $3,467.37 Typical High $5,011.87 | Facility | None | $549.54 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $707.95 | Professional | None | $549.54 | $549.54 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $812.83 Typical High $1,096.48 | Professional | None | $501.19 | $812.83 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $512.86 Typical High $691.83 | Professional | 62 · Two surgeons | $316.23 | $512.86 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $131.83 Typical High $186.21 | Professional | 80 · Assistant surgeon | $79.43 | $131.83 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $114.82 Typical High $154.88 | Professional | AS · PA/NP assist | $69.18 | $114.82 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,318.26 Typical High $2,630.27 | Facility | None | $630.96 | $1,318.26 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $1,071.52 | Professional | None | $537.03 | $724.44 | $1,071.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $2,089.30 Typical High $2,951.21 | Facility | None | $954.99 | $2,089.30 | $2,951.21 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $1,096.48 | Professional | None | $616.60 | $891.25 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,230.27 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,096.48 | Professional | None | $524.81 | $691.83 | $1,096.48 |
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 $275.42 Median $275.42 Typical High $354.81 | Professional | 52 · Reduced service | $275.42 | $275.42 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $141.25 | Professional | 53 · Discontinued | $109.65 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $537.03 | Professional | 54 · Surgery only | $407.38 | $407.38 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $107.15 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $501.19 |
Where Indiana sits
The same service costs 5.2 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· 33rd of 51
$813
AK $2,344UT $447
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.