How much rates vary
Facilitymedian $12,303 · 10th to 90th $912 to $30,903Professionalmedian $1,023 · 10th to 90th $871 to $1,585
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 $912.01 Median $3,467.37 Typical High $5,011.87 | Facility | None | $912.01 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $912.01 Typical High $1,122.02 | Professional | None | $891.25 | $912.01 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $20,892.96 Typical High $32,359.37 | Facility | None | $2,691.53 | $20,892.96 | $32,359.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,412.54 | Professional | None | $812.83 | $1,023.29 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $645.65 Typical High $912.01 | Professional | 62 · Two surgeons | $512.86 | $645.65 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $162.18 Typical High $251.19 | Professional | 80 · Assistant surgeon | $131.83 | $162.18 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $144.54 Typical High $204.17 | Professional | AS · PA/NP assist | $114.82 | $144.54 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,288.25 Typical High $2,691.53 | Facility | None | $575.44 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,621.81 | Professional | None | $870.96 | $1,202.26 | $1,621.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,187.76 Typical High $2,754.23 | Facility | None | $912.01 | $2,187.76 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,445.44 | $1,949.84 |
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 $831.76 Median $1,148.15 Typical High $1,819.70 | Professional | None | $831.76 | $1,148.15 | $1,819.70 |
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 $446.68 Median $446.68 Typical High $562.34 | Professional | 52 · Reduced service | $446.68 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $223.87 | Professional | 53 · Discontinued | $177.83 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $851.14 | Professional | 54 · Surgery only | $676.08 | $676.08 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $91.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $89.13 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $794.33 |
Where Indiana sits
The same service costs 18.6 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· 38th of 51
$1,122
AK $4,169TX $224
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.