How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,380 to $25,119Professionalmedian $513 · 10th to 90th $372 to $724
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 $426.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $426.58 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $562.34 | Professional | None | $426.58 | $426.58 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $10,471.29 Typical High $28,840.32 | Facility | None | $1,995.26 | $10,471.29 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $691.83 | Professional | None | $371.54 | $512.86 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $758.58 Typical High $1,047.13 | Professional | 50 · Both sides | $562.34 | $758.58 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $323.59 Typical High $446.68 | Professional | 62 · Two surgeons | $234.42 | $323.59 | $446.68 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $81.28 Typical High $120.23 | Professional | 80 · Assistant surgeon | $58.88 | $81.28 | $120.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $70.79 Typical High $95.50 | Professional | AS · PA/NP assist | $52.48 | $70.79 | $95.50 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $5,888.44 | Facility | None | $436.52 | $436.52 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,630.78 Typical High $6,760.83 | Facility | None | $549.54 | $3,630.78 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $741.31 | Professional | None | $389.05 | $524.81 | $741.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,122.02 Median $6,025.60 Typical High $8,511.38 | Facility | None | $1,122.02 | $6,025.60 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $812.83 | Professional | None | $446.68 | $537.03 | $812.83 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $794.33 | Professional | None | $398.11 | $501.19 | $794.33 |
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 $208.93 Median $208.93 Typical High $251.19 | Professional | 52 · Reduced service | $208.93 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | 53 · Discontinued | $85.11 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | 54 · Surgery only | $316.23 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $354.81 |
Where Indiana sits
The same service costs 9.5 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· 42nd of 51
$537
OK $3,236UT $339
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.