How much rates vary
Facilitymedian $9,550 · 10th to 90th $813 to $21,380Professionalmedian $1,023 · 10th to 90th $724 to $1,413
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 $812.83 Median $3,467.37 Typical High $5,011.87 | Facility | None | $812.83 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $977.24 | Professional | None | $741.31 | $812.83 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $14,125.38 Typical High $22,908.68 | Facility | None | $1,862.09 | $14,125.38 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,380.38 | Professional | None | $676.08 | $1,047.13 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $660.69 Typical High $891.25 | Professional | 62 · Two surgeons | $426.58 | $660.69 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $165.96 Typical High $234.42 | Professional | 80 · Assistant surgeon | $109.65 | $165.96 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $144.54 Typical High $194.98 | Professional | AS · PA/NP assist | $95.50 | $144.54 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $1,318.26 Typical High $1,995.26 | Facility | None | $851.14 | $1,318.26 | $1,995.26 |
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 $831.76 Median $977.24 Typical High $1,621.81 | Professional | None | $831.76 | $977.24 | $1,621.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,041.74 Typical High $2,238.72 | Facility | None | $912.01 | $2,041.74 | $2,238.72 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,513.56 | Professional | None | $812.83 | $1,000.00 | $1,513.56 |
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 $776.25 Median $954.99 Typical High $1,479.11 | Professional | None | $776.25 | $954.99 | $1,479.11 |
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 $371.54 Median $407.38 Typical High $489.78 | Professional | 52 · Reduced service | $371.54 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $194.98 | Professional | 53 · Discontinued | $147.91 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $616.60 Typical High $724.44 | Professional | 54 · Surgery only | $562.34 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $147.91 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $97.72 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $575.44 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $524.81 | $575.44 | $676.08 |
Where Indiana sits
The same service costs 6.3 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· 31st of 51
$1,047
AK $3,388UT $537
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.