How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,023 to $24,547Professionalmedian $708 · 10th to 90th $490 to $977
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 $562.34 Median $5,011.87 Typical High $14,125.38 | Facility | None | $562.34 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $602.56 | Professional | None | $549.54 | $562.34 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $10,232.93 Typical High $28,183.83 | Facility | None | $1,445.44 | $10,232.93 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $954.99 | Professional | None | $489.78 | $707.95 | $954.99 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $446.68 Typical High $602.56 | Professional | 62 · Two surgeons | $309.03 | $446.68 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $114.82 Typical High $162.18 | Professional | 80 · Assistant surgeon | $77.62 | $114.82 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $100.00 Typical High $134.90 | Professional | AS · PA/NP assist | $69.18 | $100.00 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $5,888.44 | Facility | None | $602.56 | $602.56 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,467.37 Typical High $6,456.54 | Facility | None | $676.08 | $3,467.37 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,071.52 | Professional | None | $616.60 | $724.44 | $1,071.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,479.11 Median $6,025.60 Typical High $8,511.38 | Facility | None | $1,479.11 | $6,025.60 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,071.52 | Professional | None | $588.84 | $776.25 | $1,071.52 |
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 $489.78 Median $645.65 Typical High $1,023.29 | Professional | None | $489.78 | $645.65 | $1,023.29 |
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 $275.42 Median $281.84 Typical High $302.00 | Professional | 52 · Reduced service | $275.42 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $120.23 | Professional | 53 · Discontinued | $109.65 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $446.68 | Professional | 54 · Surgery only | $416.87 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $83.18 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $60.26 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $416.87 |
Where Indiana sits
The same service costs 8.1 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
$708
OK $3,467UT $427
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.