How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,072 to $19,498Professionalmedian $1,820 · 10th to 90th $1,288 to $2,570
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 $1,380.38 Median $5,011.87 Typical High $11,220.18 | Facility | None | $1,380.38 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,380.38 | $1,659.59 |
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 $1,174.90 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,862.09 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $1,174.90 Typical High $1,584.89 | Professional | 62 · Two surgeons | $741.31 | $1,174.90 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $302.00 Typical High $426.58 | Professional | 80 · Assistant surgeon | $190.55 | $302.00 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $263.03 Typical High $354.81 | Professional | AS · PA/NP assist | $165.96 | $263.03 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $5,248.07 | Facility | None | $1,445.44 | $1,445.44 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,548.13 Typical High $5,888.44 | Facility | None | $630.96 | $3,548.13 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,778.28 | $2,951.21 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,995.26 Median $5,623.41 Typical High $7,413.10 | Facility | None | $1,995.26 | $5,623.41 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,778.28 | $2,630.27 |
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 $1,348.96 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,698.24 | $2,754.23 |
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 $691.83 Median $691.83 Typical High $831.76 | Professional | 52 · Reduced service | $691.83 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $331.13 | Professional | 53 · Discontinued | $275.42 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,174.90 |
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· 32nd of 51
$1,862
AK $5,623UT $977
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.