How much rates vary
Facilitymedian $3,311 · 10th to 90th $794 to $8,913Professionalmedian $832 · 10th to 90th $603 to $1,175
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 $676.08 Median $5,011.87 Typical High $14,125.38 | Facility | None | $676.08 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $870.96 | Professional | None | $676.08 | $676.08 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $1,122.02 | Professional | None | $588.84 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,258.93 Typical High $1,737.80 | Professional | 50 · Both sides | $870.96 | $1,258.93 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $524.81 Typical High $724.44 | Professional | 62 · Two surgeons | $371.54 | $524.81 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $134.90 Typical High $190.55 | Professional | 80 · Assistant surgeon | $93.33 | $134.90 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $117.49 Typical High $162.18 | Professional | AS · PA/NP assist | $81.28 | $117.49 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $1,995.26 | Facility | None | $707.95 | $707.95 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,348.96 Typical High $2,630.27 | Facility | None | $676.08 | $1,348.96 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,230.27 | Professional | None | $645.65 | $851.14 | $1,230.27 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $3,311.31 | Facility | None | $1,479.11 | $2,137.96 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,288.25 | Professional | None | $707.95 | $870.96 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,288.25 | Professional | None | $660.69 | $812.83 | $1,288.25 |
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 $338.84 Median $338.84 Typical High $407.38 | Professional | 52 · Reduced service | $338.84 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 53 · Discontinued | $134.90 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $602.56 | Professional | 54 · Surgery only | $501.19 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $562.34 |
Where Indiana sits
The same service costs 6.0 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· 39th of 51
$832
OK $2,884UT $479
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.