How much rates vary
Facilitymedian $3,890 · 10th to 90th $891 to $9,120Professionalmedian $1,202 · 10th to 90th $871 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 $1,148.15 | Professional | None | $912.01 | $912.01 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $5,248.07 Typical High $9,549.93 | Facility | None | $933.25 | $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 $269.15 | Professional | 80 · Assistant surgeon | $125.89 | $190.55 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $169.82 Typical High $223.87 | Professional | AS · PA/NP assist | $109.65 | $169.82 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,995.26 | Facility | None | $954.99 | $954.99 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,548.82 Typical High $2,691.53 | Facility | None | $630.96 | $1,548.82 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,905.46 | Professional | None | $912.01 | $1,174.90 | $1,905.46 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,479.11 Median $2,290.87 Typical High $3,801.89 | Facility | None | $1,479.11 | $2,290.87 | $3,801.89 |
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 $1,174.90 Typical High $1,819.70 | Professional | None | $891.25 | $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 $457.09 Median $457.09 Typical High $575.44 | Professional | 52 · Reduced service | $457.09 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | 53 · Discontinued | $181.97 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $870.96 | Professional | 54 · Surgery only | $676.08 | $676.08 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $173.78 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $812.83 |
Where Indiana sits
The same service costs 5.6 times more in Alaska than in Texas. 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
$1,202
AK $3,715TX $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.