How much rates vary
Facilitymedian $3,802 · 10th to 90th $851 to $8,913Professionalmedian $490 · 10th to 90th $372 to $708
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 $426.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $426.58 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $501.19 | Professional | None | $380.19 | $426.58 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $660.69 | Professional | None | $354.81 | $489.78 | $660.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $223.87 Median $309.03 Typical High $426.58 | Professional | 62 · Two surgeons | $223.87 | $309.03 | $426.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $56.23 Median $79.43 Typical High $112.20 | Professional | 80 · Assistant surgeon | $56.23 | $79.43 | $112.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $69.18 Typical High $95.50 | Professional | AS · PA/NP assist | $48.98 | $69.18 | $95.50 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $3,467.37 | Facility | None | $436.52 | $436.52 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,570.40 Typical High $3,801.89 | Facility | None | $645.65 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $794.33 | Professional | None | $407.38 | $524.81 | $794.33 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,071.52 Median $3,548.13 Typical High $4,570.88 | Facility | None | $1,071.52 | $3,548.13 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $776.25 | Professional | None | $426.58 | $524.81 | $776.25 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $741.31 | Professional | None | $380.19 | $467.74 | $741.31 |
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 $190.55 Median $208.93 Typical High $251.19 | Professional | 52 · Reduced service | $190.55 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $85.11 Typical High $100.00 | Professional | 53 · Discontinued | $75.86 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $316.23 Typical High $371.54 | Professional | 54 · Surgery only | $288.40 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $63.10 Typical High $74.13 | Professional | 55 · Aftercare only | $57.54 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $38.02 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $295.12 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $269.15 | $295.12 | $346.74 |
Where Indiana sits
The same service costs 10.2 times more in Oklahoma 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· 42nd of 51
$501
OK $2,951UT $288
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.