How much rates vary
Facilitymedian $5,370 · 10th to 90th $832 to $19,055Professionalmedian $1,349 · 10th to 90th $1,000 to $1,950
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 $1,071.52 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,071.52 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,071.52 | $1,412.54 |
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 $977.24 Median $1,348.96 Typical High $1,819.70 | Professional | None | $977.24 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $851.14 Typical High $1,148.15 | Professional | 62 · Two surgeons | $602.56 | $851.14 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $218.78 Typical High $309.03 | Professional | 80 · Assistant surgeon | $154.88 | $218.78 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $190.55 Typical High $257.04 | Professional | AS · PA/NP assist | $134.90 | $190.55 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $5,248.07 | Facility | None | $1,174.90 | $1,174.90 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,162.28 Typical High $5,754.40 | Facility | None | $588.84 | $3,162.28 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,380.38 | $2,089.30 |
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 $1,202.26 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,737.80 | $2,137.96 |
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 $1,096.48 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,380.38 | $2,187.76 |
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 $537.03 Median $537.03 Typical High $707.95 | Professional | 52 · Reduced service | $537.03 | $537.03 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $281.84 | Professional | 53 · Discontinued | $213.80 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $1,047.13 | Professional | 54 · Surgery only | $812.83 | $812.83 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $213.80 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $141.25 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $977.24 |
Where Indiana sits
The same service costs 5.8 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· 39th of 51
$1,349
AK $4,677UT $813
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.