How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,023 to $19,498Professionalmedian $759 · 10th to 90th $525 to $1,175
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 $5,011.87 Typical High $16,595.87 | Facility | None | $549.54 | $5,011.87 | $16,595.87 |
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 $1,479.11 Median $11,481.54 Typical High $23,988.33 | Facility | None | $1,479.11 | $11,481.54 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $891.25 Typical High $1,174.90 | Professional | None | $501.19 | $891.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $562.34 Typical High $758.58 | Professional | 62 · Two surgeons | $316.23 | $562.34 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $144.54 Typical High $204.17 | Professional | 80 · Assistant surgeon | $79.43 | $144.54 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $125.89 Typical High $169.82 | Professional | AS · PA/NP assist | $69.18 | $125.89 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,754.23 | Facility | None | $602.56 | $1,819.70 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,691.53 Typical High $4,897.79 | Facility | None | $630.96 | $2,691.53 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,174.90 | Professional | None | $549.54 | $724.44 | $1,174.90 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,090.30 Typical High $7,079.46 | Facility | None | $954.99 | $3,090.30 | $7,079.46 |
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 $549.54 Median $691.83 Typical High $1,096.48 | Professional | None | $549.54 | $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 $269.15 Median $269.15 Typical High $354.81 | Professional | 52 · Reduced service | $269.15 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $144.54 | Professional | 53 · Discontinued | $109.65 | $109.65 | $144.54 |
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 9.8 times more in Oklahoma 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· 26th of 51
$891
OK $4,365UT $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.