How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,000 to $15,136Professionalmedian $912 · 10th to 90th $617 to $1,230
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 $660.69 Median $3,467.37 Typical High $5,011.87 | Facility | None | $660.69 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $870.96 | Professional | None | $660.69 | $660.69 | $870.96 |
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 $602.56 Median $912.01 Typical High $1,230.27 | Professional | None | $602.56 | $912.01 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $575.44 Typical High $776.25 | Professional | 62 · Two surgeons | $380.19 | $575.44 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $147.91 Typical High $208.93 | Professional | 80 · Assistant surgeon | $97.72 | $147.91 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $128.82 Typical High $173.78 | Professional | AS · PA/NP assist | $85.11 | $128.82 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $891.25 Typical High $2,691.53 | Facility | None | $562.34 | $891.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,258.93 | Professional | None | $660.69 | $870.96 | $1,258.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,819.70 Typical High $2,187.76 | Facility | None | $912.01 | $1,819.70 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,348.96 | Professional | None | $758.58 | $1,096.48 | $1,348.96 |
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 $660.69 Median $851.14 Typical High $1,348.96 | Professional | None | $660.69 | $851.14 | $1,348.96 |
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 $331.13 Median $331.13 Typical High $436.52 | Professional | 52 · Reduced service | $331.13 | $331.13 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $173.78 | Professional | 53 · Discontinued | $131.83 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $645.65 | Professional | 54 · Surgery only | $501.19 | $501.19 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $128.82 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $87.10 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $602.56 |
Where Indiana sits
The same service costs 5.4 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· 36th of 51
$912
AK $2,884UT $537
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.