How much rates vary
Facilitymedian $9,772 · 10th to 90th $832 to $21,878Professionalmedian $1,995 · 10th to 90th $1,413 to $2,818
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 $1,584.89 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,584.89 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,584.89 | $1,584.89 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $14,454.40 Typical High $22,908.68 | Facility | None | $1,995.26 | $14,454.40 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,258.93 Typical High $1,698.24 | Professional | 62 · Two surgeons | $851.14 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $316.23 Typical High $446.68 | Professional | 80 · Assistant surgeon | $213.80 | $316.23 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $275.42 Typical High $371.54 | Professional | AS · PA/NP assist | $186.21 | $275.42 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $3,235.94 | Professional | None | $1,513.56 | $1,949.84 | $3,235.94 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $4,265.80 | Facility | None | $912.01 | $2,290.87 | $4,265.80 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,621.81 | $1,995.26 | $2,951.21 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,513.56 | $1,949.84 | $2,951.21 |
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 $776.25 Median $776.25 Typical High $954.99 | Professional | 52 · Reduced service | $776.25 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | 53 · Discontinued | $316.23 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $281.84 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,318.26 |
Where Indiana sits
The same service costs 5.9 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· 30th of 51
$1,995
AK $6,457TX $1,096
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.