How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,000 to $15,136Professionalmedian $933 · 10th to 90th $661 to $1,318
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 $707.95 Median $5,011.87 Typical High $11,220.18 | Facility | None | $707.95 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,000.00 | Professional | None | $707.95 | $707.95 | $1,000.00 |
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 $645.65 Median $933.25 Typical High $1,258.93 | Professional | None | $645.65 | $933.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $588.84 Typical High $794.33 | Professional | 62 · Two surgeons | $407.38 | $588.84 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $151.36 Typical High $213.80 | Professional | 80 · Assistant surgeon | $104.71 | $151.36 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $131.83 Typical High $177.83 | Professional | AS · PA/NP assist | $91.20 | $131.83 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $1,412.54 | Facility | None | $776.25 | $933.25 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,230.27 Typical High $2,691.53 | Facility | None | $575.44 | $1,230.27 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,318.26 | Professional | None | $691.83 | $933.25 | $1,318.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,949.84 Typical High $2,187.76 | Facility | None | $912.01 | $1,949.84 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,445.44 | Professional | None | $812.83 | $1,148.15 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,445.44 | Professional | None | $707.95 | $891.25 | $1,445.44 |
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 $354.81 Median $354.81 Typical High $501.19 | Professional | 52 · Reduced service | $354.81 | $354.81 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $199.53 | Professional | 53 · Discontinued | $141.25 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $758.58 | Professional | 54 · Surgery only | $537.03 | $537.03 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $151.36 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $100.00 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $707.95 |
Where Indiana sits
The same service costs 5.9 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· 38th of 51
$933
AK $3,090TX $525
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.