How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,000 to $14,454Professionalmedian $1,230 · 10th to 90th $891 to $1,738
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 $954.99 Median $5,011.87 Typical High $11,220.18 | Facility | None | $954.99 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,258.93 | Professional | None | $954.99 | $954.99 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,096.48 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $1,659.59 | Professional | None | $812.83 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $776.25 Typical High $1,047.13 | Professional | 62 · Two surgeons | $512.86 | $776.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $199.53 Typical High $281.84 | Professional | 80 · Assistant surgeon | $131.83 | $199.53 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $173.78 Typical High $234.42 | Professional | AS · PA/NP assist | $114.82 | $173.78 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $3,467.37 | Facility | None | $1,000.00 | $1,000.00 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,454.71 Typical High $3,715.35 | Facility | None | $630.96 | $2,454.71 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,995.26 | Professional | None | $933.25 | $1,202.26 | $1,995.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,995.26 Median $3,548.13 Typical High $5,011.87 | Facility | None | $1,995.26 | $3,548.13 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,819.70 | Professional | None | $977.24 | $1,202.26 | $1,819.70 |
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 $933.25 Median $1,174.90 Typical High $1,819.70 | Professional | None | $933.25 | $1,174.90 | $1,819.70 |
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 $478.63 Median $478.63 Typical High $588.84 | Professional | 52 · Reduced service | $478.63 | $478.63 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $234.42 | Professional | 53 · Discontinued | $190.55 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $870.96 | Professional | 54 · Surgery only | $707.95 | $707.95 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $177.83 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $117.49 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $812.83 |
Where Indiana sits
The same service costs 5.9 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
$1,230
OK $4,074UT $692
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.