How much rates vary
Facilitymedian $9,550 · 10th to 90th $1,175 to $21,380Professionalmedian $955 · 10th to 90th $661 to $1,380
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 $707.95 Median $5,011.87 Typical High $14,125.38 | Facility | None | $707.95 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $870.96 | Professional | None | $660.69 | $707.95 | $870.96 |
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 $660.69 Median $1,023.29 Typical High $1,348.96 | Professional | None | $660.69 | $1,023.29 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $645.65 Typical High $870.96 | Professional | 62 · Two surgeons | $407.38 | $645.65 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $162.18 Typical High $229.09 | Professional | 80 · Assistant surgeon | $104.71 | $162.18 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $141.25 Typical High $190.55 | Professional | AS · PA/NP assist | $91.20 | $141.25 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
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 $724.44 Median $912.01 Typical High $1,479.11 | Professional | None | $724.44 | $912.01 | $1,479.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,995.26 Typical High $2,187.76 | Facility | None | $912.01 | $1,995.26 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,445.44 | Professional | None | $794.33 | $977.24 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $4,168.69 Typical High $9,120.11 | Facility | None | $1,096.48 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,412.54 | Professional | None | $724.44 | $933.25 | $1,412.54 |
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 $331.13 Median $354.81 Typical High $426.58 | Professional | 52 · Reduced service | $331.13 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $173.78 | Professional | 53 · Discontinued | $131.83 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $645.65 | Professional | 54 · Surgery only | $489.78 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $128.82 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $87.10 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $602.56 |
Where Indiana sits
The same service costs 8.5 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· 31st of 51
$1,023
OK $3,162TX $372
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.