How much rates vary
Facilitymedian $6,761 · 10th to 90th $977 to $19,055Professionalmedian $1,202 · 10th to 90th $851 to $1,660
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 $933.25 Median $5,011.87 Typical High $11,220.18 | Facility | None | $933.25 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,230.27 | Professional | None | $933.25 | $933.25 | $1,230.27 |
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 $794.33 Median $1,230.27 Typical High $1,659.59 | Professional | None | $794.33 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $776.25 Typical High $1,047.13 | Professional | 62 · Two surgeons | $501.19 | $776.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $199.53 Typical High $281.84 | Professional | 80 · Assistant surgeon | $128.82 | $199.53 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $173.78 Typical High $234.42 | Professional | AS · PA/NP assist | $112.20 | $173.78 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $10,000.00 | Facility | None | $954.99 | $954.99 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,754.40 Typical High $10,471.29 | Facility | None | $645.65 | $5,754.40 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,778.28 | Professional | None | $891.25 | $1,148.15 | $1,778.28 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $13,489.63 | Facility | None | $1,995.26 | $8,511.38 | $13,489.63 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,778.28 | Professional | None | $954.99 | $1,174.90 | $1,778.28 |
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 $912.01 Median $1,148.15 Typical High $1,778.28 | Professional | None | $912.01 | $1,148.15 | $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 $616.60 | Professional | 52 · Reduced service | $457.09 | $457.09 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $245.47 | Professional | 53 · Discontinued | $186.21 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $933.25 | Professional | 54 · Surgery only | $691.83 | $691.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $123.03 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $870.96 |
Where Indiana sits
The same service costs 6.3 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· 34th of 51
$1,230
OK $4,169UT $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.