How much rates vary
Facilitymedian $4,074 · 10th to 90th $891 to $9,120Professionalmedian $1,202 · 10th to 90th $851 to $1,698
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 $912.01 Median $5,011.87 Typical High $11,220.18 | Facility | None | $912.01 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,122.02 | Professional | None | $912.01 | $912.01 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $5,248.07 Typical High $9,549.93 | Facility | None | $954.99 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $1,621.81 | Professional | None | $794.33 | $1,202.26 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $758.58 Typical High $1,023.29 | Professional | 62 · Two surgeons | $501.19 | $758.58 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $190.55 Typical High $275.42 | Professional | 80 · Assistant surgeon | $125.89 | $190.55 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $169.82 Typical High $229.09 | Professional | AS · PA/NP assist | $112.20 | $169.82 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $3,467.37 | Facility | None | $954.99 | $954.99 | $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 $912.01 Median $1,174.90 Typical High $1,949.84 | Professional | None | $912.01 | $1,174.90 | $1,949.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,995.26 Median $3,548.13 Typical High $6,309.57 | Facility | None | $1,995.26 | $3,548.13 | $6,309.57 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,737.80 | Professional | None | $954.99 | $1,174.90 | $1,737.80 |
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 $891.25 Median $1,122.02 Typical High $1,778.28 | Professional | None | $891.25 | $1,122.02 | $1,778.28 |
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 $457.09 Median $457.09 Typical High $562.34 | Professional | 52 · Reduced service | $457.09 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 53 · Discontinued | $186.21 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | 54 · Surgery only | $691.83 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $776.25 |
Where Indiana sits
The same service costs 6.2 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
$1,202
OK $4,074UT $661
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.