How much rates vary
Facilitymedian $9,772 · 10th to 90th $891 to $25,119Professionalmedian $1,514 · 10th to 90th $1,072 to $2,188
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 $1,202.26 Median $5,011.87 Typical High $17,782.79 | Facility | None | $1,202.26 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,202.26 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $15,488.17 Typical High $26,915.35 | Facility | None | $2,238.72 | $15,488.17 | $26,915.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,621.81 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $1,023.29 Typical High $1,380.38 | Professional | 62 · Two surgeons | $630.96 | $1,023.29 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $257.04 Typical High $354.81 | Professional | 80 · Assistant surgeon | $162.18 | $257.04 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $223.87 Typical High $302.00 | Professional | AS · PA/NP assist | $141.25 | $223.87 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $1,288.25 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,513.56 | $2,511.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,235.94 | Facility | None | $912.01 | $2,290.87 | $3,235.94 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,513.56 | $2,238.72 |
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 $1,174.90 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,174.90 | $1,445.44 | $2,238.72 |
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 $562.34 Median $602.56 Typical High $724.44 | Professional | 52 · Reduced service | $562.34 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $245.47 Typical High $288.40 | Professional | 53 · Discontinued | $223.87 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $912.01 Typical High $1,096.48 | Professional | 54 · Surgery only | $831.76 | $912.01 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $181.97 Typical High $218.78 | Professional | 55 · Aftercare only | $165.96 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $120.23 Typical High $144.54 | Professional | 56 · Pre-op care only | $112.20 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $851.14 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $776.25 | $851.14 | $1,023.29 |
Where Indiana sits
The same service costs 7.1 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· 24th of 51
$1,622
AK $5,012TX $708
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.