How much rates vary
Facilitymedian $5,495 · 10th to 90th $933 to $19,055Professionalmedian $891 · 10th to 90th $631 to $1,259
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 $912.01 | Professional | None | $707.95 | $707.95 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $10,964.78 Typical High $22,908.68 | Facility | None | $1,122.02 | $10,964.78 | $22,908.68 |
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 $144.54 Typical High $208.93 | Professional | 80 · Assistant surgeon | $97.72 | $144.54 | $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 $741.31 Median $741.31 Typical High $5,248.07 | Facility | None | $741.31 | $741.31 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,754.23 Typical High $5,754.40 | Facility | None | $645.65 | $2,754.23 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,348.96 | Professional | None | $676.08 | $891.25 | $1,348.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,819.70 Median $5,370.32 Typical High $7,413.10 | Facility | None | $1,819.70 | $5,370.32 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,348.96 | Professional | None | $724.44 | $891.25 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,288.25 | Professional | None | $691.83 | $851.14 | $1,288.25 |
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 $416.87 | Professional | 52 · Reduced service | $354.81 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $630.96 | Professional | 54 · Surgery only | $524.81 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $83.18 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $588.84 |
Where Indiana sits
The same service costs 8.7 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· 35th of 51
$912
OK $4,365UT $501
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.