How much rates vary
Facilitymedian $9,772 · 10th to 90th $912 to $24,547Professionalmedian $1,660 · 10th to 90th $1,202 to $2,344
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 $1,380.38 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,380.38 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,380.38 | $1,659.59 |
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 $1,202.26 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,698.24 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,071.52 Typical High $1,445.44 | Professional | 62 · Two surgeons | $758.58 | $1,071.52 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $275.42 Typical High $389.05 | Professional | 80 · Assistant surgeon | $194.98 | $275.42 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $239.88 Typical High $323.59 | Professional | AS · PA/NP assist | $169.82 | $239.88 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,621.81 Typical High $2,691.53 | Facility | None | $562.34 | $1,621.81 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,584.89 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,801.89 | Facility | None | $912.01 | $2,290.87 | $3,801.89 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,630.27 | Professional | None | $1,445.44 | $1,737.80 | $2,630.27 |
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 $1,258.93 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,584.89 | $2,511.89 |
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 $630.96 Median $691.83 Typical High $831.76 | Professional | 52 · Reduced service | $630.96 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $275.42 Typical High $331.13 | Professional | 53 · Discontinued | $257.04 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,047.13 Typical High $1,230.27 | Professional | 54 · Surgery only | $954.99 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $208.93 Typical High $251.19 | Professional | 55 · Aftercare only | $190.55 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $138.04 Typical High $165.96 | Professional | 56 · Pre-op care only | $128.82 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $977.24 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $891.25 | $977.24 | $1,148.15 |
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· 31st of 51
$1,698
AK $5,754TX $813
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.