How much rates vary
Facilitymedian $10,233 · 10th to 90th $1,259 to $39,811Professionalmedian $1,380 · 10th to 90th $977 to $1,995
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 $1,096.48 Median $5,011.87 Typical High $17,782.79 | Facility | None | $1,096.48 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,318.26 | Professional | None | $1,000.00 | $1,096.48 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,513.56 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,479.11 Typical High $1,949.84 | Professional | None | $912.01 | $1,479.11 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $933.25 Typical High $1,258.93 | Professional | 62 · Two surgeons | $575.44 | $933.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $234.42 Typical High $331.13 | Professional | 80 · Assistant surgeon | $144.54 | $234.42 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $208.93 Typical High $281.84 | Professional | AS · PA/NP assist | $128.82 | $208.93 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $10,232.93 | Facility | None | $1,148.15 | $1,148.15 | $10,232.93 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $10,964.78 | Facility | None | $891.25 | $6,606.93 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,348.96 | $2,041.74 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $10,232.93 Typical High $15,135.61 | Facility | None | $2,089.30 | $10,232.93 | $15,135.61 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,348.96 | $1,995.26 |
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 $1,071.52 Median $1,288.25 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,288.25 | $2,041.74 |
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 $501.19 Median $549.54 Typical High $660.69 | Professional | 52 · Reduced service | $501.19 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $263.03 | Professional | 53 · Discontinued | $199.53 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $977.24 | Professional | 54 · Surgery only | $758.58 | $831.76 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $194.98 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $131.83 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $912.01 |
Where Indiana sits
The same service costs 8.7 times more in Oklahoma 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· 34th of 51
$1,479
OK $6,166TX $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.