How much rates vary
Facilitymedian $5,370 · 10th to 90th $813 to $19,055Professionalmedian $1,122 · 10th to 90th $759 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 $812.83 Median $5,011.87 Typical High $7,244.36 | Facility | None | $812.83 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,071.52 | Professional | None | $812.83 | $812.83 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $10,964.78 Typical High $22,908.68 | Facility | None | $794.33 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $1,548.82 | Professional | None | $741.31 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $724.44 Typical High $977.24 | Professional | 62 · Two surgeons | $467.74 | $724.44 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $186.21 Typical High $263.03 | Professional | 80 · Assistant surgeon | $117.49 | $186.21 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $162.18 Typical High $218.78 | Professional | AS · PA/NP assist | $102.33 | $162.18 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $5,248.07 | Facility | None | $891.25 | $891.25 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $3,090.30 Typical High $5,754.40 | Facility | None | $562.34 | $3,090.30 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,584.89 | Professional | None | $812.83 | $1,071.52 | $1,584.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,659.59 Median $5,370.32 Typical High $7,413.10 | Facility | None | $1,659.59 | $5,370.32 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $1,621.81 | Professional | None | $912.01 | $1,318.26 | $1,621.81 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,621.81 | Professional | None | $831.76 | $1,023.29 | $1,621.81 |
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 $407.38 Median $407.38 Typical High $537.03 | Professional | 52 · Reduced service | $407.38 | $407.38 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $213.80 | Professional | 53 · Discontinued | $162.18 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $794.33 | Professional | 54 · Surgery only | $616.60 | $616.60 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $158.49 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $107.15 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $741.31 |
Where Indiana sits
The same service costs 5.6 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
$1,148
AK $3,548UT $631
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.